来氟米特与霉酚酸酯治疗表现为肾病综合征的过敏紫癜性肾炎的疗效比较

Comparison Between Leflunomide and Mycophenolate Mofeil Treatment in Nephropathy Syndrome Caused by Henoch-Schonlein Purpura Nephritis

目的:比较来氟米特(LEF)与霉酚酸酯(MMF)治疗临床表现为肾病综合征的过敏紫癜性肾炎(HSPN)的临床疗效。方法:36例临床表现为肾病综合征的HSPN患者,分别采用激素联合LEF治疗(LEF组,n=18),或采用激素联合MMF治疗(MMF组,n=18)。LEF或MMF正规使用6个月以上。收集治疗前及治疗6个月以后的血尿常规、尿红细胞计数、24h尿蛋白定量、肝肾功能、白蛋白及血脂等指标,同时记录不良反应。结果:(1)两组接受治疗后,尿蛋白和尿红细胞计数均明显减少(P<0.01),血白蛋白明显上升(P<0.01)。(2)临床缓解率:LEF组总有效率为83.3%,MMF组总有效率为88.8%,两组之间无统计学差异;其中完全缓解率分别为50.0%和44.4%,部分缓解率分别为33.3%和44.4%,均无统计学差异(P>0.05)。(3)两组患者均耐受良好,无明显副作用。结论:LEF和MMF联合激素治疗表现为肾病综合征的HSPN的临床缓解率相似,不良反应轻微。

Objective： To compare the clinical efficiency between leflunomide and mycophenolate mofeil treatment in nephropathy syndrome caused by Henoch - Schonlein purpura nephritis （HSPN）. Methods： 36 nephropathy syndrome patients caused by HSPN were randomly divided into two groups. One group received leflunomide and prednisolone, and the other group mycophenolate mofeil and prednisolone. All patients were treated for more than 6 months. A series of experimental data was observed before and after the treatment for 6 months. Results： （1）After treatment, the proteinuria and urinary RBC count were deceased significantly （ P 〈 0.01 ）, and serum albumin was increased significantly （ P 〈 0.01 ） in both groups. （2） The total efficiency rates in LEF and MMF Group were 83.3 % and 88.8 % respectively; the complete remission rates were 50.0 % and 44.4 % respectively , and the partial remission rates 33.3 % and 44.4 % respectively. There was no significant differences between the LEF group and the MMF group （ P 〉 0.05）. （3） No serious side effects were observed in both groups. Conclusion： The Clinical efficiency rate of treating nephropathy syndrome by Henoch - Schonlein purpura nephritis is of no significant difference between Leflunomide and mycophenolate mofeil with fewer complications.