摘要
目的研究来氟米特(LEF)联合尿激酶和黄芪治疗成人原发性肾病综合征(PNS)的临床疗效及安全性。方法将50例PNS患者随机分为治疗组(n=26)和对照组(n=24),对照组进行常规的糖皮质激素加来氟米特治疗,治疗组在对照组的基础上联用尿激酶和黄芪治疗,观察疗效及副作用,并通过实验室检查评价尿激酶和黄芪对肾功能及凝血功能的作用。结果 (1)治疗组26例患者中完全缓解14例,显著缓解6例,部分缓解4例,无效2例,对照组24例患者中完全缓解9例,显著缓解4例,部分缓解5例,无效6例,治疗组疗效显著高于对照组(Z=-2.403,P=0.016)。(2)两组治疗后的血清清蛋白、尿蛋白、总胆固醇(TC)、血清肌酐(SCr)、尿素氮(BUN)、纤维蛋白原(FIB)水平与治疗前比较,差异均有统计学意义(P<0.05)。治疗前两组患者的尿蛋白、清蛋白、TC、SCr、BUN及FIB水平比较,差异均无统计学意义(P均>0.05);而治疗后除TC外,上述各指标间差异均有统计学意义(P均<0.05)。结论来氟米特是治疗成人PNS有效的免疫抑制剂,其副作用可以耐受,尿激酶和黄芪可改善肾功能,降低血液的高凝状态,联合应用治疗PNS效果显著。
Objective To investigate the clinical efficacy and safety of co-administration of leflunomide（LEF） plus urokinase and radix astragali in the treatment of primary nephrotic syndrome（PNS）.Methods 50 PNS patients were divided into the treatment group （n=26） and the control group （n=24） randomly.The patients in the control group received the general treatment with prednisone and LEF,while the treatment group received the co-administration of prednisone and LEF plus urokinase and radix astragali.Then observe the therapeutic efficacy and side reaction,and evaluate their effect on renal function and blood coagulation by laboratory technology.Results After 6 months treatment,the percentage of complete remission and obvious remission in treatment group were 53.6%,23.3%,while the control group were 37.5%,16.7%,the difference was significant（Z=-2.403,P=0.016）.The items of seralbumin,urine protein,TC,SCr,BUN,FIB were significantly decreased in the two groups compared with baseline（P0.05）,while the serum creatinine and fibrinogen increased more obviously in the treatment group（P0.05）.Conclusion LEF is an effective and safe immunosuppressive agent for PNS with tolerable side effects.Urokinase and radix astragali can improve renal function and relieve the hypercoagulability,combined use of them for PNS can reach ideal therapeutic efficacy.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第30期3444-3446,共3页
Chinese General Practice
基金
广东省自然科学基金(8151001002000006)
关键词
肾病综合征
来氟米特
尿激酶
黄芪
治疗
Nephrotic syndrome
Leflunomide
Urokinase
Radix astragali
Treatment
