来氟米特和环磷酰胺分别联合激素用于难治性肾病综合征治疗的疗效比较

The efficacy of leflunomide combined with hormone versus that of cyclophosphamide plus hormone for refractory nephrotic syndrome

目的探究难治性肾病综合征的最佳治疗方法。方法将我院收治的难治性肾病综合征病人70例，分为实验组与对照组，实验组在激素治疗的基础上加用来氟米特，对照组在激素治疗的基础上加用环磷酰胺。观察比较实验组与对照组患者的生化指标改变情况和临床疗效。结果实验组与对照组用药后胆固醇、三酰甘油水平和24h尿蛋白定量都显著下降，白蛋白水平明显升高（P〈0．05）；两组之间相比，实验组白蛋白水平和24h尿蛋白定量变化更显著（P〈0．05）。实验组总有效率为82．9％，对照组总有效率为74．3％（P〉0．05）。结论难治性肾病综合征的最佳治疗方法：来氟米特联合糖皮质激素，该方法生化指标改善显著，有效率高，在临床上应首选此方法。

Objective To explore the optimal therapy for refractory nephrotic syndrome. Methods 70 patients with refractory nephrotic syndrome were divided into stduygroup and control group. The study group received leflunomide in addition to hormone therapy, while the control group received cyclophosphamide plus hormone. The changes in biochemical indicators and the clinical efficacy were compared between the two groups. Results Levels of cholesterol, triglyceride, and 24h urinary protein were significantly declined and albumin levels were significantly increased in both groups after treatment （ P〈 0.05 The changes in levels of albumin and 24 h urinary protein were more significant in the study group than in the control group （ P〈 0.05 ）. The total effectiveness rate was 82.9% in the study group and 74.3% in the control group （ P 〉 0.05 ）. Conclusions Leflunomide combined with glucocorticoids is the optimal therapy for refractory nephrotic syndrome, with a higher effectiveness rate. This method makes biochemical indicators improve significantly and should be the first choice in clinical practice.