来氟米特联合强的松对原发性IgA肾病患者24h尿蛋白、血肌酐水平的影响

Effects of leflunomide combined with prednisone on 24h urinary protein and blood creatinine levels in patients with primary IgA nephropathy

目的探究来氟米特联合强的松对原发性免疫球蛋白A(IgA)肾病患者24h尿蛋白、血肌酐(Scr)水平的影响.方法回顾性分析2018年2月~2019年10月我院收治的115例原发性IgA肾病患者临床资料,根据治疗方案不同进行分组,将57例使用强的松治疗的患者纳入对照组,将58例使用来氟米特联合强的松治疗的患儿纳入观察组.比较两组治疗前、治疗6个月后24h尿蛋白、血尿素氮(BUN)、Scr及不良反应情况.结果治疗前,两组24h尿蛋白、BUN、Scr对比,差异无统计学意义(P>0.05);治疗6个月后,两组24h尿蛋白、Scr、BUN均降低,且观察组变化更大,差异有统计学意义(P<0.05).治疗期间,两组不良反应发生率对比,差异无统计学意义(P>0.05).结论原发性IgA肾病患者采用来氟米特联合强的松治疗可以降低血肌酐及血尿素氮,减少尿蛋白丢失,改善肾功能,且安全性较高,值得推广.

0bjective To investigate theeffect of leflunomide combined with prednisoneon 24h urine protein and serum creatinine(Scr)levels in patients with primary immunoglobulinA(IgA)nephropathy.Methods Retrospectivelyanalyzed the clinical data of 115 patients with primary IgA nephropathy who were received by our hospital from February 2018 to October 2019.They were grouped according to different treatment regimens.58 children who were treated with leflunomide combined with prednisone were included in the observation group.The urinary protein,blood urea nitrogen(BUN),Scr and adverse reactions were compared between the two groups before treatment and 24h after 6 months of treatment.Results Before treatment,there was no significant difference in urine protein,BUN,and Scr between the two groups at 24 hours(P>O.05);after 6 months of treatment,urine protein,Scr,and BUN at both groups in both groups were decreased,and the observation group changed most,the difference was statistically significant(P〈O.OS).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conelusion The treatment of patients with primary IgA nephropathy with leflunomide combined with prednisone can reduce blood creatinine and blood urea nitrogen,reduce urinary protein loss,improve renal function,and has high safety.It is worth promoting.