治疗弥漫增殖性狼疮肾炎的临床对照研究

Clinical study of treatment on diffuse proliferate lupus nephritis

目的应用来氟米特（LEF）联合强的松治疗弥漫增殖性狼疮肾炎（DPLN）患者，探讨LEF治疗狼疮肾炎的疗效及安全性。方法选择经病理证实DPLN患者40例，根据随机、开放的原则，分为治疗组20例和对照组20例。治疗组：LEF联合强的松治疗，对照组：环磷酰胺（CTX）联合强的松治疗，观察周期均为6个月。观察两组的疗效，监测两组治疗前和治疗后1、3、6个月的24h尿蛋白定量、血浆白蛋白、血肌酐、补体C3的水平变化，并分别记录不良反应。结果两组治疗前、后比较：24h尿蛋白定量明显降低，血浆白蛋白明显升高，补体C3水平显著升高，而血肌酐无明显变化。两组间各指标相比差异无统计学意义（P均〉0．05），但治疗组与对照组相比不良反应的发生率明显减少（P〈0．05）。结论对照组与治疗组相比疗效相当，不良反应明显减少。

Objective To study leflunomide plus prednisone in treating patients with diffuse proliferate lupus nephritis and discuss the curative effect and security. Methods Forty patients with diffuse proliferate lupus nephritis who were pathology confirmed, according to the principle of opening and random,were divided into treatment group （20 cases）and the control group （20 cases）. Treatment group were given leflunomide combined with prednisone, control group applyed cyclophosphamide and prednisone. Obversing the curative effect, monitoring the 24 - hour urine protein quantitation, serum albumin, serum creatinine, and blood complement component C3 changes of the two groups and recording adverse reactions pretherapy and post -treatment for one month, three months and six months. Results Compared treatment group with control group of prior - treatment, the differences were not statistically significant. Compared treatment group with control group of post - treatment, the differences still were not statis- tically significant （ P 〉 0. 05 ）. The indexes compared prior - treatment with post - treatment of two groups, both showed that urine protein significantly decreased, serum albumin significantly increased, complement component C3 significantly increased and serum creatinine remained unchanged. The incidence of adverse reactions was significantly less in the treatment group compared with control group, the difference was statistically significant （ P 〈 0. 05）. Conclusions The effect of leflunomide plus prednisone in treating lupus nephritis was reliable and adverse reactions were less.