来氟米特与雷公藤多苷治疗IgA肾病对照研究(1)
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【摘要】 目的 观察来氟米特(LEF)、雷公藤多苷联合激素治疗IgA肾病的疗效和安全性。方法 收集符合条件的60例中等量蛋白尿IgA肾病患者随机分为2组，试验组LEF联合中等量激素治疗，对照组雷公藤多苷联合中等量激素治疗，观察治疗前、后1、3、6个月的相关临床指标变化，并进行评价。结果 试验组治疗后24 h尿蛋白定量显著减少(P<0.01)，血清白蛋白显著升高(P<0.01)，完全缓解率为46.4%，总有效率为85.7%。与对照组比较疗效差异无统计学意义(P>0.05)。观察组起效快，不良反应轻微，患者耐受性好。结论 来氟米特联合激素可以作为治疗IgA肾病的选择之一，且安全、有效。
【关键词】
来氟米特；IgA肾病；雷公藤多苷
Control study Lefunomide and triptolide in treating IgA nephropathy
CHANG Jing, ZHANG Wenjuan, SONG Xiuqin, et al.
Department of Nephrology, Yantai Hill Hospital,Yantai 264000, China
【Abstract】 Objective
To investigate the infects and safety of Lefunomide(LEF) combined with medium dose glucocorticoid,and Triptolide with medium dose glucocorticoid for IgA nephropathy with medium albuminuria. Methods Sixty patients with IgA nephropathy with medium albuminuria were devided into two groups at random.The patients in test group were treated with LEF combined with medium dose glucocorticoid.The patients in control group received Triptolide with medium dose glucocorticoid. Clinical data were observed and evaluated in months 1,3 and 6 during the treatment. Results After receiving LEF therapy,the proteinuria in the test group decreased siganificantly (P<0.01) and serum albumin increased significantly (P<0.01).The complete relieving rate was 46.4%,the total efficient rate was 85.7%.Contractedwith triptolide,the efficiency of LEF on treating IgA nephropathy was not statistically different (P>0.05). LEF can act more quickly than triptolide,the side effects were mild and all patients tolerated this therapy. Conclusion LEF combined with medium dose glucocorticoid therapy can be one of the safety and effective choices for treatment of IgA nephropathy.
【Key words】
Lefunomide; IgA nephropathy; Triptolide
作者单位：264000烟台市烟台山医院肾内科
IgA肾病是我国慢性肾小球肾炎最常见的病理类型之一，约占39.15%[1]。目前认为IgA肾病是一种进展性疾病，明确诊断后每10年约有20%的患者进展至终末期肾病[2]，目前国内外尚无统一有效的方案。比较一致的看法是IgA肾病是一种免疫复合物性肾炎[3]。来氟米特(luflunomide，LEF)作为一种新型免疫抑制剂，能抑制免疫反应的多个阶段而发挥其治疗作用。本研究观察LEF、雷公藤多苷联合激素治疗中等量蛋白尿IgA肾病的疗效和安全性，报告如下。
1 资料与方法
1.1 一般资料 选择2002年1月至2009年1月在本院符合原发性IgA肾病诊断标准的患者共60例 ......
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