来氟米特治疗IgA肾病的临床研究

A randomized paralled clinical control study on IgA nephropathy treatd with leflunomide.

目的采用随机平行对照临床观察来氟米特(商品名爱诺华)治疗56例IgA肾病的疗效。方法56例lgA肾病患者均选自四川大学华西医院2004年1-9月门诊及住院病人。其中肾病综合征患者22例,经爱诺华加激素治疗12例,激素加CTX治疗10例;非肾病综合征患者34例,分为爱诺华治疗组(17例)与雷公藤多甙治疗组(17例)。结果肾病综合征患者:两组疗效相同,但经爱诺华治疗组不良事件发生明显低于使用CTX组。非肾病综合征:雷公藤多甙治疗组疗效明显低于爱诺华组。56例IgA肾病患者使用爱诺华治疗的总有效率为82.76%。结论使用爱诺华治疗lgA肾病,在肾病综合征病人,可以取得与CTX治疗相似的效果,但不良事件发生率较低,病人依从性较高。非肾病综合征病人,使用爱诺华可避免由雷公藤多甙所引起的女性病人闭经。

Objective We performed a randomized control and paralleled clinical study to determine effects of leflunomide on IgA nephropathy in out-patients and inpatients during Jan. -Sept. of 2004. Methods Fifty-six patients with IgA nephropathy were classified according to whether they were accompanied by nephrotic syndrome (NS) or not (Non-NS) . There were 22 patients in the NS group and 34 in the non-NS group. Twelve patients in the NS group were treated by the leflunomide and hormone therapy,and the other 10 patients were treated by cyclophosphamide (CTX) and hormone therapy; 17 patients in the non-NS group were treated by the leflunomide therapy,and the other 17 patients were treated by the Lei Gong Teng therapy. Results Two therapies in the NS group had the same effects, but the therapy containing leflunomide had less adverse effects than the therapy of CTX. In the non-NS group, leflunomide had better curative effects than Lei Gong Teng. The total response rate resulting from the therapies containing leflunomide used in the NS and non-NS groups was 82.76% . Conclusion Treatment with leflunomide for IgA nephropathy with NS has the same effects as treatment of CTX,but has less adverse effects and better compliance. Patients with IgA nephropathy but with no NS respond better to leflunomide than to Lei Gong Teng. For women patients, leflunomide can also avoid menopause caused by Lei Gong Teng.