来氟米特在增殖型狼疮性肾炎维持缓解治疗中的作用

Leflunomide as maintenance therapy for proliferative lupus nephritis

目的:评估来氟米特(LEF)在增殖型狼疮性肾炎(LN)维持缓解治疗中的有效性及安全性。方法:2002年10月1日~2014年9月30日期间在北京大学第一医院肾内科经肾活检病理确诊为增殖型LN的患者为研究对象,具有完整的临床、实验室、病理及随访资料,并已进入维持缓解治疗期。根据维持缓解治疗药物种类,将患者分为LEF组与非LEF组,进行临床、病理及预后分析。结果:本研究共纳入66例LN患者,其中LEF组16例,非LEF组50例。2组在基线临床、病理特征上无显著性差异(均P>0.05)。诱导治疗结束后的完全缓解率在LEF组显著低于非LEF组(12.5%vs 40%,χ^2=4.125,P=0.042)。随访过程中2组的复发率、肌酐倍增和死亡均无显著性差异(均P>0.05)。2组患者维持缓解期的不良事件发生率无显著性差异(均P>0.05)。结论:来氟米特作为增殖型LN的维持缓解药物具有一定的有效性和安全性。

Objective:To evaluate the efficacy and safety of leflunomide(LEF)in the maintenance therapy of proliferative lupus nephritis.Methods:Patients with biopsy-proven lupus nephritis from 1 st Oct.2002 to 30 th Sep.2014 were included.They were all under regular follow-up in our outpatient clinic and all the clinical and laboratory data were collected both from the onset and during follow-up.According to different maintenance therapy methods,patients were divided into LEF group and non-LEF group.The clinical,pathological and follow-up data were analyzed.Results:A total of 66 patients were enrolled,16 in the LEF group and 50 in the non-LEF group.No statistical difference was found in the baseline clinical and pathological characteristics between the two groups except the complete remission rate(12.5%vs 40.0%,χ^2=4.125,P=0.042).There were no significant differences in relapse rate,doubling of serum creatinine and death during the follow-up.Both groups had no significant difference in adverse effects.Conclusion:Leflunomide is effective and safe in maintenance therapy of proliferative lupus nephritis.