来氟米特治疗难治性肾病综合征60例临床研究

Clinical trial on the effect of leflunomide in treating refractory nephropathy syndrome

目的观察长程应用来氟米特联合泼尼松治疗难治性肾病综合征患者的疗效和安全性。方法2000-11～2003-05收集中山大学附属第三医院的难治性肾病综合征病人60例,随机分为两组,分别为接受来氟米特联合泼尼松治疗组(观察组),接受吗替麦考酚酯联合泼尼松治疗组(对照组)。观察治疗2、4、6、8、12、16、20、24、28周的相关临床指标变化及其评价。结果来氟米特组治疗后24h尿蛋白定量显著减少(P<0.05),血清白蛋白显著升高(P<0.05),完全缓解率为56.67%,总有效率为80%。与吗替麦考酚酯组比疗效差异无显著性(P>0.05),来氟米特组12周内显效率高于吗替麦考酚酯组(P<0.05),不良反应轻微,所有病人耐受性良好。结论来氟米特能够有效缓解难治性肾病综合征。

Objective To investigate the effect of leflunomide and prednisone in treating refractory nephmpathy syndrome, Methods The 60 refractory nephmpathy patients in our hospital from Oct, 2000 to May, 2003 were divided into two groups at random. Paients in test group received leflunomide and prednisone, Patients in control group received mycophenolate mofetil and prednisone. Clinical data were observed in the 2nd, 4th, 6th, 8th, 12th, 16th, 20th, 24th and 28th week. Results After receiving leflunomide therapy in the test group, the proteinuria was decreased significantly （P 〈 0.05 ） ; serum albumin was increased significantly （P 〈 0, 05 ） ; complete relieving rate was 56. 67%, and total effective rate was 80%. Contracted with mycophenolate mofetil, the efficacy of leflunomide on treating refractory nephropathy syndrome was no statistically different （P 〉 0.05 ） , but rate of showing efficacy in 12th week in Leflunomide group was higher than mycophenolate mofetil group （ P 〈 0.05 ）, side effects were mild. All patients could tolerate this therapy. Conclusion Leflunomide is a safe and effective medicine in treating refractory neohrooathv syndrome.