论文部分内容阅读
目的观察来氟米特联合吗替麦考酚酯治疗狼疮性肾炎的临床疗效。方法选择辽宁医学院附属第一医院2011年4月至2013年4月风湿免疫科住院的狼疮性肾炎的患者100例,随机分为治疗组和对照组,每组各50例,治疗组给予来氟米特联合吗替麦考酚酯治疗,对照组只采用环磷酰胺冲击治疗,疗程均为9个月。用药前常规测1次血常规、尿常规、24 h尿蛋白定量,血生化系列(肝、肾功能、血脂、血浆蛋白、肌酶),免疫学指标[抗核抗体(ANA)、抗双链DNA(ds-DNA)抗体、补体C3、补体C4]。用药半个月后复查以上指标,此后每1个月测1次以上指标。结果治疗组的血浆白蛋白、补体C3、C4较治疗前明显上升,组间比较差异有统计学意义(P<0.05),血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白总量、系统性红斑狼疮疾病活动度评分(SLEDAI)评分较治疗前明显下降,组间比较差异有统计学意义(P<0.05),联合治疗组的ANA阳性率、抗ds-DNA抗体阳性率治疗后明显下降,组间比较差异有统计学意义(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论来氟米特联合吗替麦考酚酯治疗狼疮性肾炎的疗效明显优于单独环磷酰胺冲击治疗,且不良反应不增加。
Objective To observe the clinical efficacy of leflunomide combined with mycophenolate mofetil in the treatment of lupus nephritis. Methods 100 cases of lupus nephritis hospitalized in the First Affiliated Hospital of Liaoning Medical University from April 2011 to April 2013 were randomly divided into treatment group and control group, 50 cases in each group. The treatment group was given Leflunomide combined with mycophenolate mofetil treatment, the control group only treated with cyclophosphamide shock treatment were 9 months. The blood routine, urine routine, 24 h urinary protein quantitation, blood biochemical series (liver, kidney function, blood lipid, plasma protein and muscle enzyme), immunological indicators [ANA, anti-double stranded DNA (ds-DNA) antibody, complement C3, complement C4]. After reviewing the above indicators half a month after treatment, measured every 1 month after the above indicators. Results The levels of plasma albumin, complement C3 and C4 in the treatment group were significantly higher than those before treatment (P <0.05). The levels of serum creatinine (Scr), blood urea nitrogen (BUN), 24 h urinary protein (P <0.05). The positive rates of ANA and anti-dsDNA antibody in the combined treatment group were significantly lower than those before treatment (P <0.05). There was a significant difference between the two groups (P <0.05). There was no significant difference in adverse reactions between the two groups (P> 0.05). Conclusion Leflunomide combined with mycophenolate mofetil treatment of lupus nephritis was significantly better than the impact of cyclophosphamide alone, and adverse reactions did not increase.