来氟米特治疗难治性肾病综合征临床分析

The clinical analysis of leflunomide on refractory nephrotic syndrome

目的观察来氟米特对难治性肾病综合征的治疗效果。方法选择难治性肾病综合征患者58例,随机分为治疗组与对照组,治疗组在激素治疗的基础上加用来氟米特治疗,对照组在激素治疗的基础上加用环磷酰胺静脉治疗。观察并比较两组患者的生化指标和临床疗效。结果治疗组与对照组用药后总胆固醇、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,治疗组血清白蛋白水平和24h尿蛋白定量变化更显著(P<0.05)。治疗后6个月和1年治疗组的总有效率分别为69.44%、83.33%,对照组的总有效率分别为59.09%、72.73%(P>0.05)。治疗组不良反应发生率为11.11%,低于对照组的40.91%,差异有统计学意义(P<0.05)。结论来氟米特治疗难治性肾病综合征安全有效,不良反应小,患者耐受性好。

To investigate the clinical effects of leflunomide on the treatment of refractory nephrotic syndrome. Methods 58 patients with refractory nephrotic syndrome were divided into the treatment group（n=36） and the control group（n=22） randomly. The treatment group received cyclophosphamide and hormone,while the control group received lefluno- mide and hormone. Observed and compared the clinical effects and biochemical criterion of the two groups. Results Levels of total cholesterol,triglyceride,and 24h urinary protein were significantly declined and albumin levels were significantly increased in both groups after treatment（P〈0.05）. Compared between the two groups, the albumin and 24h urinary protein of the treatment group were more significant（P〈0.05）. After 6 months and one year treatment, the total remission rate of the treatment group were 69.44% and 83.33%,the control group were 59.09% and 72.73%,P〈0.05. The adverse effects rate of treatment group（11.11%） was lower than control group（40.91%）,P〈0.05. Conclusion Leflunomide is safe and effective for refractory nephritic syndrome patients.