来氟米特联合雷公藤多苷治疗IgA肾病临床研究.docVIP

来氟米特联合雷公藤多苷治疗IgA肾病临床研究 　　[摘要] 目的：观察来氟米特联合雷公藤多苷治疗IgA肾病的临床效果。方法：将IgA肾病患者80例随机分为治疗组和对照组，各40例。治疗组给予来氟米特联合雷公藤多苷，对照组给予依那普利，疗程均为12个月。结果：治疗组总有效率为87.5％（35/40），对照组为62.5％（25/40），差异有统计学意义（χ2=12.56，P＜0.05)。治疗组治疗后尿蛋白为（0.63±0.21） g/24 h，血清白蛋白为（41.32±13.42） g/L，均较治疗前及与对照组治疗后差异有统计学意义（均P＜0.05）。结论：两药联用治疗IgA肾病患者能提高患者的血清白蛋白，显著降低患者的尿蛋白，副作用少。 　　[关键词] IgA肾病；来氟米特；雷公藤多苷 　　[中图分类号] R692[文献标识码]A [文章编号]1673-7210（2011）04（b）-067-02 　　 　　Clnical study of Leflunomide combined with Tripterygium Wilfordii in treatment of IgA nephropathy 　　SUI Jianying 　　Department of Nephrology, the 4th Hospital of Daqing City, Daqing 163000, China 　　[Abstract] Objective: To observe the clinical efficacy of Leflunomide combined with Tripterygium Wilfordii on IgA nephropathy. Methods: 80 patients were randomly divided into treatment group and control group, each group contained 40 cases. The treatment group was given Leflunomide combined with Tripterygium Wilfordii, and the control group with given Enalapril, and both group continued for therapeutical period of 12 months. Results: Total effective rate of treatment group with 87.5% was obviously higher than the control group′s 62.5%, and there was statistical difference (χ2=12.56, P＜0.05). After treatment, urine protein of treatment group was (0.63±0.21) g/24h, and serum albumin was (41.32±13.42) g/L, both compared with those of control group has statistical difference(all P＜0.05). Conclusion: Leflunomide combined with Tripterygium Wilfordii could difinitely reduce urine protein and raise serum albumin of IgA nephropathy, with less side effect. 　　[Key words] IgA nephropathy; Leflunomide; Tripterygium Wilfordii 　　 　　IgA肾病是IgA或其循环免疫复合物沉积在肾小球引起肾小球病理损害，是我国多发的肾小球疾病之一，临床表现多样，主要表现为蛋白尿、血尿、水肿及腰酸等。目前尚无特效的治疗方法，以延缓或防止肾功能进行性恶化、改善或缓解临床症状及防治严重并发症为主。雷公藤多苷是从中药雷公藤中分离出的有效化学成分，来氟米特是一种新型免疫抑制剂，本研究采用来氟米特联合雷公藤多苷治疗IgA肾病，取得较好的效果，现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　选择2008年10月～2010年10月在我院就诊的原发性IgA肾病患者80例。入选标准：经肾穿刺确诊，Lee氏分级为Ⅲ～Ⅳ级且为中等程度蛋白尿及以上（＞1 g/d）、低蛋白血症（血浆白蛋白＜35 g/L），无肉眼血尿，血肌酐正常。所有入选患者均排除