来氟米特联合雷公藤多苷治疗难治性肾病综合征临床观察

Effect of leflunomide combined with tripterygium glycosides in treatment of refactory nephrotic syndrome

目的观察来氟米特、雷公藤多苷联合治疗难治性肾病综合征疗效。方法选择64例难治性肾病综合征患者，根据用药情况分为治疗组34例，在常规治疗基础上的加来氟米特联合雷公藤多苷，对照组30例仅给予常规治疗，如环磷酰胺联合泼尼松，30d后，观察两组的疗效及随访情况。结果治疗组的有效率94．1％明显高于对照组70．0％。1年后进行随访，治疗组的复发率17．6％明显低于对照组36．7％。两组的24h尿蛋白明显降低，ALB均较治疗前升高，三酰甘油、TCh均较治疗前明显降低，且治疗组降低的和升高的程度均明显优于对照组（P〈0．05）。结论来氟米持、雷公藤多苷联合治疗难治性肾病综合征疗效好，复发率低，可以明显改善患者的肝。肾功能，降血脂，值得临床广泛推广和应用。

Objective To observe the effect of leflunomide, combined tripterygium glycosides in treatment of nephrotic syndrome. Methods 64 patients with refractory nephrotic syndrome, according to drug using were divided into two groups ,34 patients received the conventional therapy plus leflunomide combined tripterygium glycosides,30 patients received conventional therapy alone, such as cyclophosphamide and prednisone, effects and follow-up were observed, as well as kidney function, blood lipid changes. Results After 30d treatment,the efficacy were observed. The results showed the efficiency of the observation group were significantly higher than control group. After 1 year followup,the recurrence rate of the observation group was significantly lower than the control group. 24h urine protein in both groups decreased significantly, ALB was higher than before treatment,TG TCh was significantly lower than before treatment, and different indexes in the treatment group were significantly better than after the reduction and increase the level of the control group （ P 〈 0.05 ）. Conclusion Leflunomide,tripterygium glycosides combined treatment of nephrotic syndrome had good effect,and recurrence rate was low,and it could improve kidney function,blood fat,it was worthy of wide dissemination and application.