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目的评价来氟米特治疗难治性肾病综合征的疗效和安全性。方法电子检索Medline、Embase、Cochrane系统评价和临床试验数据库,CBM和CNKI等数据库,收集来氟米特治疗肾病综合征的随机或半随机对照试验,检索时间均截止至2007年12月。对纳入研究进行质量评价,并用RevMan 4.2软件进行Meta分析。结果共纳入7个研究,均为中文文献,其中3个试验质量评分为C级,4个试验质量评分为B级。Meta分析结果显示,与对照组相比,来氟米特治疗难治性肾病综合征的完全缓解率和有效率差别无统计学意义(P>0.05),来氟米特的不良反应发生率高于吗替麦考酚酯。结论来氟米特治疗难治性肾病综合征是具有一定临床疗效的,由于纳入的研究质量不高,存在着选择性偏倚、测量性偏倚的可能性,有必要进一步开展高质量、大样本随机对照试验评价其疗效和安全性。
Objective To evaluate the efficacy and safety of leflunomide in the treatment of refractory nephrotic syndrome. Methods The databases of Medline, Embase, Cochrane Database of Systematic Reviews and Clinical Trials, CBM and CNKI were searched electronically. Randomized or quasi-randomized controlled trials of leflunomide in the treatment of nephrotic syndrome were collected electronically until December 2007. The included studies were evaluated for quality and Meta-analysis was performed using RevMan 4.2 software. Results A total of 7 studies were included, all of which were Chinese. Among them, three of the three trials had a C grade and four of the B tests had a B grade. Meta-analysis showed that, compared with the control group, leflunomide treatment of refractory nephrotic syndrome, the complete remission rate and the effective rate was no significant difference (P> 0.05), leflunomide adverse reactions were high In mycophenolate mofetil Conclusion Leflunomide treatment of refractory nephrotic syndrome is a certain clinical efficacy, due to the quality of the included studies is not high, there is the possibility of selective bias, measurement bias, it is necessary to further carry out high-quality, large sample of random Control trial to evaluate the efficacy and safety.