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目的观察来氟米特(LEF)联合泼尼松治疗难治性原发性肾病综合征的疗效及安全性。方法选择我院30例难治性原发性肾病综合征患者,均给予口服来氟米特50 mg/d,共3 d,后以20 mg/d维持,同时口服泼尼松30 mg/d,疗程为2个月。在治疗前及治疗后2、4、8周末检测患者的血白细胞计数、丙氨酸转氨酶(ALT)、尿蛋白定量(24 h)、血清白蛋白含量(ALB)、血肌酐。疗程结束后,评定其临床疗效及安全性。结果 30例患者治疗后第2、4、8周末的尿蛋白定量(24 h)均低于治疗前(P<0.01);治疗后第2、4、8周末的血清白蛋白含量均高于治疗前(P<0.01)。治疗前后血白细胞计数、ALT、血肌酐差异均无统计学意义。治疗过程中2例患者出现胃肠道反应,1例皮肤瘙痒,未做特殊处理,均自行缓解。结论来氟米特联合泼尼松治疗难治性肾病综合征有效、安全、可行。
Objective To observe the efficacy and safety of leflunomide (LEF) plus prednisone in the treatment of refractory primary nephritic syndrome. Methods Thirty patients with refractory idiopathic nephrotic syndrome in our hospital were given orally leflunomide 50 mg / d for 3 days and then maintained at 20 mg / day, while oral prednisone 30 mg / d , Treatment for 2 months. Blood leukocyte counts, ALT, urine protein (24 h), serum albumin (ALB) and serum creatinine were measured before treatment and at 2, 4 and 8 weeks after treatment. After the end of treatment, assess its clinical efficacy and safety. Results The urinary protein (24 h) at the end of the 2nd, 4th and the 8th week after treatment in 30 patients was lower than that before treatment (P <0.01); the serum albumin contents at the 2nd, Before (P <0.01). Before and after treatment, white blood cell count, ALT, serum creatinine differences were not statistically significant. Two patients in the course of treatment of gastrointestinal reactions, one case of itchy skin, without special treatment, are on their own ease. Conclusion Leflunomide combined with prednisone is effective, safe and feasible for the treatment of refractory nephrotic syndrome.