来氟米特治疗类风湿性关节炎合并肾损害的临床观察

Clinical observation of leflunomide in the treatment of rheumatoid arthritis complicated with renal damage

目的 探讨来氟米特治疗类风湿性关节炎合并肾损害的临床疗效及安全性.方法 选取60例类风湿性关节炎合并肾损害患者,分为观察组和对照组各30例,对照组给予糖皮质激素常规治疗,观察组口服来氟米特.停药后观察两组患者生化指标变化,并评价临床疗效及安全性.结果 治疗后3个月随访24 h尿蛋白定量、CRP、ESR和关节晨僵均较治疗前显著下降（P＜0.05）,且观察组上述各项指标下降幅度显著大于对照组（P＜0.01）.两组临床症状缓解率对比差异有统计学意义（86.7％vs,76.7％,P＜0.05）.结论 来氟米特治疗类风湿性关节炎合并肾损害疗效值得肯定,能明显缓解患者临床症状,可作为治疗该病的理想药物选择.不过,关于来氟米特的远期疗效及不良反应尚待进一步观察.

Objective To investigate the clinical effect and safety of leflunomide in the treatment of rheumatoid arthritis complicated with renal damage.Methods 60 case of rheumatoid arthritis complicated with renal damage were selected and divided into observation group and control group, 30 cases in each group.Control group received glucocorticoid for routine treatment, while observation group received oral administration of leflunomide.After stopping the use of the drugs, observed changes of biochemical indexes of two groups, and evaluated the clinical effect and safety.Results 3 months after treatment, 24 h urine protein quantitative, CRP, ESR and joint early morning stiffness decreased significantly compared with before treatment （P〈0.05）, the decline degrees of indexes mentioned above in observation group were significantly larger than those in control group （P〈0.01）.There was statistically significant difference in the remission rate of clinical symptoms between two groups （86.7% vs.76.7%, P〈0.05）.Conclusions Leflunomide has significant curative effect in the treatment of rheumatoid arthritis complicated with renal damage, which can alleviate obviously clinical symptoms of patients, can be used as the ideal option for the treatment of the disease.However, the long-term curative effect and adverse reactions of leflunomide remain to be seen.