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目的研究来氟米特治疗IgA肾病有效性及安全性。方法 80例IgA肾病患者,按照随机数字法分为实验组和对照组,各40例。实验组采用来氟米特治疗,对照组采用环磷酰胺治疗,比较两组患者临床疗效及不良反应发生情况。结果实验组无效3例,有效7例,显效18例,完全缓解12例;对照组无效11例,有效6例,显效12例,完全缓解11例。实验组治疗总有效率为92.5%,对照组治疗总有效率为72.5%,实验组的治疗总有效率明显高于对照组,差异具有统计学意义(P<0.05)。实验组胃肠道反应1例,谷丙转氨酶(ALT)升高1例,白细胞下降1例,出血性膀胱炎1例,感染1例;对照组胃肠道反应1例,ALT升高2例,白细胞下降3例,出血性膀胱炎1例,感染2例。实验组不良反应发生率为12.5%,对照组不良反应发生率为22.5%,实验组的不良反应发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论采用来氟米特治疗IgA肾病具有治疗总有效率高、不良反应发生率低等优点,有很高的临床推广价值。
Objective To study the efficacy and safety of leflunomide in the treatment of IgA nephropathy. Methods Eighty IgA nephropathy patients were divided into experimental group and control group according to random number method, 40 cases in each group. The experimental group was treated with leflunomide, while the control group was treated with cyclophosphamide. The clinical efficacy and adverse reactions of the two groups were compared. Results The experimental group was ineffective in 3 cases, effective in 7 cases, markedly effective in 18 cases, complete remission in 12 cases; the control group was ineffective in 11 cases, effective in 6 cases, markedly effective in 12 cases, complete remission in 11 cases. The total effective rate of the experimental group was 92.5%, while that of the control group was 72.5%. The total effective rate of the experimental group was significantly higher than that of the control group (P <0.05). 1 case of gastrointestinal tract reaction, 1 case of elevated alanine aminotransferase (ALT), 1 case of leukopenia, 1 case of hemorrhagic cystitis, 1 case of infection; 1 case of gastrointestinal reaction in control group and 2 cases of ALT increase , Leukopenia in 3 cases, hemorrhagic cystitis in 1 case and infection in 2 cases. The incidence of adverse reactions in the experimental group was 12.5%, the incidence of adverse reactions in the control group was 22.5%, and the incidence of adverse reactions in the experimental group was significantly lower than that in the control group (P <0.05). Conclusion Leflunomide treatment of IgA nephropathy has the advantages of high total effective rate of treatment, low incidence of adverse reactions, and has a high clinical value.