来氟米特联合糖皮质激素治疗难治性肾病综合征临床研究.docVIP

来氟米特联合糖皮质激素治疗难治性肾病综合征临床研究 　　[摘要] 目的：探讨来氟米特联合糖皮质激素治疗难治性肾病综合征的临床疗效及价值。方法：对我院2008年7月～2010年7月收治的86例肾病综合征患者，采用来氟米特联合糖皮质激素治疗，对治疗后2、4、12、24周患者的症状、体征及血浆白蛋白、24 h尿白蛋白和血肌酐水平等相关结果以及治疗后3～6个月的随访记录进行回顾性分析和研究。结果：治疗总有效率为76.74%（66/86），尤其在系膜增生性非IgA肾小球肾炎和系膜增生性IgA肾病的治疗效果最为明显，有效率分别为87.50%（14/16），90.00%（18/20），总复发率为6.98%（6/86）。治疗后患者的血浆白蛋白、24 h尿白蛋白及血肌酐水平得到了明显改善。结论：来氟米特联合糖皮质激素治疗难治性肾病综合征基本上是安全、有效的，值得临床推广。 　　[关键词] 来氟米特；糖皮质激素；难治性肾病综合征；临床研究 　　[中图分类号] R692 [文献标识码] A [文章编号] 1673-7210（2011）06（c）-096-03 　　 　　Clinical research of leflunomide combined with glucocorticoids in the treatment of refractory nephrotic syndrome 　　ZHANG Ｊianzhong, JIANG Luxuan, ZHANG Lifang 　　The Third People′s Hospital of Chenzhou City, Hu′nan Province, Chenzhou 423000, China 　　[Abstract] Objective: To investegate clinical efficacy and value with leflunomide combined with glucocorticoids in the treatment of refractory nephrotic syndrome. Methods: 86 patients with nephrotic syndrome were treated with leflunomide combined with glucocorticoids in our hospital from July 2008 to July 2010. After 2,4,12,24 weeks treatment, the symptoms, signs, plasma albumin, 24 h urinary albumin, serum creatinine level, and other related results, and 3 to 6 months follow-up records after treatment were analyzed and researched retrospectively. Results: The total effective rate was 76.74%(66/86), especially in mesangial proliferative glomerulonephritis and minimal change disease, the treatment effect was most significant, the effective rates were 87.50%(14/16), 90.00%(18/20), the total recurrence rate was 6.98%(6/86). After treatment, serum albumin, 24 h urinary albumin and serum creatinine level were significantly improved. Conclusion: Leflunomide combined with glucocorticoids in the treatment of refractory nephrotic syndrome is basically safe and effective, it is value to promote. 　　[Key words] Leflunomide; Glucocorticoids; Refractory nephrotic syndrome; Clinical research 　　 　　难治性肾病综合征容易对激素产生抵抗和依赖，复发率高，不易治疗，来氟米特是一种新型的免疫抑制剂[1]，本院应用来氟米