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目的评价来氟米特治疗难治性肾病综合征的临床疗效及安全性。方法选择2007年3月至2010年6月在浦北县人民医院治疗的对糖皮质激素治疗不敏感、依赖或反复发作的难治性肾病综合征患者39例,均采用来氟米特联合激素治疗,观察治疗前及治疗后第4、12、24周患者各项主要指标的变化情况。结果本研究有效率为61.5%,治疗期间少数患者出现胃肠道反应、轻度脱发、丙氨酸氨基转移酶升高、皮疹等不良反应,经对症处理均可耐受;治疗后第4周出现24 h尿蛋白定量减少、血清白蛋白增高、胆固醇下降等,与治疗前比较差异有统计学意义(P<0.05),但血肌酐水平比较无明显变化(P>0.05)。结论来氟米特联合激素治疗难治性肾病综合征安全、有效,不良反应较少。
Objective To evaluate the clinical efficacy and safety of leflunomide in the treatment of refractory nephrotic syndrome. Methods From March 2007 to June 2010 in Pubei County People’s Hospital for treatment of glucocorticoid treatment is not sensitive to rely on or recurrent refractory nephrotic syndrome in 39 patients were treated with leflunomide combined with hormone The changes of the major indexes of patients before and after treatment were observed at 4, 12 and 24 weeks after treatment. Results The effective rate of this study was 61.5%. During the treatment period, a small number of patients showed gastrointestinal reactions, mild hair loss, elevated alanine aminotransferase, and rash and other adverse reactions. All the patients were tolerated symptomatically. After the 4th week 24 h urinary protein decreased, serum albumin increased, cholesterol decreased, compared with before treatment, the difference was statistically significant (P <0.05), but no significant changes in serum creatinine (P> 0.05). Conclusion Leflunomide combined with hormone treatment of refractory nephrotic syndrome is safe, effective and less adverse reactions.