来氟米特联合小剂量泼尼松对难治性肾病综合征患者肾功能及血清肌酐尿素氮水平的影响

Effects of leflunomide combined with low-dose prednisone on renal function and serum Scr and BUN levels in patients with refractory nephrotic syndrome

目的 探讨来氟米特联合小剂量泼尼松对难治性肾病综合征患者肾功能及血清肌酐、尿素氮水平的影响.方法 将92例难治性肾病综合征患者根据治疗方案分为两组各46例,观察组口服来氟米特联合小剂量泼尼松治疗,对照组口服环磷酰胺联合足量泼尼松治疗,观察6个月.治疗前后检测分析两组血清肌酐、尿素氮水平的变化,随时记录治疗过程中出现的不良反应.结果 治疗前两组血清肌酐、尿素氮水平比较差异无统计学意义（P〉0.05）,治疗后两组血清肌酐、尿素氮水平均较治疗前显著下降,且观察组显著低于对照组（P〈0.01）;观察组不良反应发生率（6.5%）显著低于对照组（21.7%）（P〈0.05）.结论 来氟米特联合小剂量泼尼松治疗难治性肾病综合征,能有效降低患者血清肌酐、尿素氮水平,改善肾功能,且高安全性,值得在临床推广应用.

Objective To investigate the effect of leflunomide combined with low-dose prednisone on renal function and serum creatinine （Scr） and urea nitrogen （BUN） levels in patients with refractory nephrotic syndrome （NS）. Methods Ninety-two patients hospitalized in our hospital were selected as research ob jects and assigned to observation group and control group of 46 ones each according to therapeutic regimen. Observation group received leflunomide combined with low-dose prednisone, control group received cyclophosphamide combined with adequate prednisone. Patients were observed for 6 months. The changes of serum Ser and BUN levels of the two groups before and after treatment were detected and analyzed. Ad erse reactions during process of the treatment were recorded at any time. Results There were no signifi cant differences in Scr and BUN levels between the two groups before treatment （P〉0.05）, the Scr and BUN levels in the two groups were decreased after treatment, and the observation group was lower than those in the control group, the difference was statistic significant （P〈0.05）; The incidence of adverse re actions in the observation group （6.5%） was lower than that in the control group （21.7%）, the difference was statistic significant （P〈0.05）. Conclusion The treatment of refractory nephrotic syndrome using leflunomide combined with low-dose prednisone can effectively reduce the serum Scr and BUN levels, im prove renal function, it has higher safety and is worthy of clinic application.