摘要
目的：评价来氟米特（LEF）治疗环磷酰胺（CTX）无效的以肾病综合征为表现的成年人过敏性紫癜性肾炎（HSPN）的临床疗效。方法选取经 CTX 治疗无效、复发或因不良反应停用的以肾病综合征为表现的 HSPN 患者26例，使用 LEF 联合糖皮质激素治疗6个月。收集治疗前及治疗后6个月的血尿常规、24 h尿蛋白定量、尿红细胞计数、血浆白蛋白、肝肾功能等指标，同时记录药物的不良反应。结果26例患者中有20例达临床缓解。与治疗前比较，有20例尿蛋白、尿红细胞计数明显减少（P ＜0．05）及血白蛋白明显上升（P ＜0．05），6例肾功能异常患者肾功能恢复正常，其中11例达完全缓解标准，9例达部分缓解，与环磷酰胺治疗无效比较，临床总缓解率达76．9％（χ2＝6．783，P ＜0．01）。有1例患者出现轻度消化道症状，1例出现轻度白细胞减少，1例出现肝功能转氨酶轻度升高，与环磷酰胺的副反应发生率（46．2％，12／26）比较，来氟米特副反应发生率为11．5％（3／26）（χ2＝5．496，P ＜0．05），均对症处理后好转，无患者停药。结论LEF 联合激素治疗 CTX 无效的表现为肾病综合征的 HSPN 有效，不良反应轻微。
Objective To evaluate the effect of leflunomide （LEF）in the treatment of adult Henoch -Schonlein purpura nephritis（HSPN）patients with nephrotic syndrome who were not response to cyclophosphamide. Methods 26 patients with nephrotic syndrome HSPN performance treated by CTX therapy,relapse or discontinued due to adverse reactions were selected.LEF joint glucocorticoid treatment was given to the patients for 6 months. Collected the blood routine,urine routine,24 hours urine protein,urinary red blood cell count,serum albumin,hepatic and renal functions before treatment and 6 months after treatment,and the adverse drug reactions were recorded. Results In 26 patients,20 cases had clinical remission.After treatment,compared with before treatment,the urinary protein,urinary red blood cell count decreased significantly（P 〈0.05）,and serum albumin increased significantly （P 〈0.05）in 20 patients,renal function recovered to normal in 6 patients.11 patients achieved complete remission, 9 patients achieved partial remission.Compared with cyclophosphamide treatment was invalid,the clinical remission rate was 76.9%（χ2 =6.783,P 〈0.01）.Of 26 patients,1 patient had mild gastrointestinal symptoms,1 patient had mild neutropenia,1 patient had mild liver transaminases elevated,compared with cyclophosphamide side effects incidence rate of 46.2%（12 /26）,the incidence rate of adverse reactions was 11.5%（3 /26）（χ2 =5.496,P 〈0.05）,they were relieved after expectant treatments,no patients stop treatment.Conclusion LEF combined with glucocorticoid had good efficacy and mild adverse reactions for adult HSPN patients with nephrotic syndrome.
出处
《中国基层医药》
CAS
2016年第23期3593-3596,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
紫癜
过敏性
肾炎
来氟米特
环磷酰胺
Purpura,Schoenlein -Henoch
Nephritis
Leflunomide
Cyclophosphamide
