来氟米特联合泼尼松治疗膜性肾病的临床观察
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篇名: 来氟米特联合泼尼松治疗膜性肾病的临床观察
TITLE:
摘要: 目的:探讨来氟米特联合泼尼松治疗膜性肾病的临床疗效及安全性。方法:将43例确诊为原发性膜性肾病的患者采用随机数字表法分为对照组(21例)和试验组(22例)。对照组患者采用环磷酰胺间断冲击联合泼尼松治疗,试验组患者采用来氟米特联合泼尼松治疗,疗程均为12个月。疗程结束后6个月,观察两组患者的临床疗效、治疗前后肾功能与血脂指标变化及不良反应发生情况。结果:试验组患者的总有效率为63.64%,显著高于对照组的23.81%,差异有统计学意义(P<0.05)。治疗后,两组患者的尿蛋白显著下降,血浆白蛋白显著升高,血清肌酐、血胆固醇、三酰甘油和低密度脂蛋白显著降低,差异均有统计学意义(P<0.05);且试验组患者上述各项指标(血胆固醇除外)较对照组变化更为显著,差异均有统计学意义(P<0.05)。试验组患者不良反应发生率为9.09%,对照组为9.52%,两组比较差异无统计学意义(P>0.05)。结论:与环磷酰胺联合泼尼松相比,来氟米特联合泼尼松对膜性肾病的疗效更为确切,肾功能和血脂指标的改善作用更为明显。
ABSTRACT: OBJECTIVE: To explore the efficacy and safety of leflunomide combined with prednison in the treatment of membranous nephropathy. METHODS: 43 patients with primary membranous nephropathy were randomly divided into control group (21 cases) and test group (22 cases). Control group given cyclophosphamide interrupted shocks combined with prednison, test group received leflunomide combined with prednison, the treatment course for both groups was 12 months. 6 months after the treatment, clinical efficacy, changes in renal function and serum lipids indexes before and after treatment, and the incidence of adverse reactions in 2 groups were observed. RESULTS: The total effective rate in test group was 63.64%, which was significantly higher than control group (23.81%), the difference was statistically significant (P<0.05). After treatment, urine protein in 2 groups significantly decreased, plasma albumin significantly increased, serum creatinine, serum cholesterol, triglycerides and low-density lipoprotein significantly decreased, the differences were statistically significant (P<0.05); and the changes of above-mentioned indexes (except blood cholesterol) in test group were more significantly than control group, the differences were statistically significant (P<0.05). The incidence of adverse reactions in test group was 9.09%, control group was 9.52%, there was no significant difference between 2 groups (P>0.05). CONCLUSIONS: Compared with cyclophosphamide interrupted shocks combined with prednison, the efficacy of leflunomide combined with prednison in the treatment of membranous nephropathy is more definite, and the improvement of renal function and serum lipids indexes is more obvious.
期刊: 2016年第27卷第23期
作者: 马亚丽,?陈芳,时军,陈宝平
AUTHORS: MA Yali,CHEN Fang,SHI Jun,CHEN Baoping
关键字: 膜性肾病;来氟米特;泼尼松;肾功能;血脂;临床疗效
KEYWORDS: Membranous nephropathy; Leflunomide; Prednison; Renal function; Serum lipid; Clinical efficacy
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