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目的观察来氟米特在治疗难治性肾病综合征(RNS)中的临床效果。方法抽取2012年8月-2013年9月来医院治疗的RNS患者80例,按照随机分组的方法随机分为观察组和对照组各40例。其中对照组给予常规激素治疗:环磷酰胺+泼尼松治疗;观察组给予上述对照组治疗加用来氟米特治疗。疗程为4个月,比较2组治疗期间24h尿蛋白定量(Upro)、血清白蛋白(ALB)、血肌酐(Scr)、血尿素氮(BUN)变化情况,及2组临床效果,不良反应情况。结果治疗4个月后,2组24h Upro、Scr及BUN与治疗前比较明显降低,ALB较治疗前明显升高(P<0.05),且观察者的24h Upro、Scr及BUN与对照组比较明显降低,ALB与对照组比较明显升高(P<0.05)。治疗4周后,观察组总缓解率为90.0%明显高于对照组的75.0%,差异均有统计学意义(P<0.05)。结论来氟米特治疗RNS特异性高,临床疗效好,不良反应少,值得临床推广应用。
Objective To observe the clinical effect of leflunomide in the treatment of refractory nephrotic syndrome (RNS). Methods Eighty patients with RNS who were hospitalized from August 2012 to September 2013 were randomly divided into observation group (40 cases) and control group (40 cases) according to the method of randomization. The control group was given conventional hormone therapy: cyclophosphamide + prednisone treatment; the observation group was given the above-mentioned control group plus leflunomide treatment. The course of treatment was 4 months. The changes of urinary protein (Upro), serum albumin (ALB), serum creatinine (Scr) and blood urea nitrogen (BUN) were compared between the two groups. The clinical effects, adverse reactions . Results After 4 months of treatment, 24h Upro, Scr and BUN in two groups were significantly lower than those before treatment, ALB was significantly higher than that before treatment (P <0.05), and 24h Upro, Scr and BUN in observation group were more obvious than those in control group (P <0.05). Compared with the control group, ALB was significantly increased (P <0.05). After 4 weeks of treatment, the total remission rate in the observation group was 90.0%, which was significantly higher than that in the control group (75.0%, P <0.05). Conclusion Leflunomide treatment of RNS high specificity, good clinical efficacy, fewer adverse reactions, it is worth promoting the clinical application.