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目的观察来氟米特联合小剂量激素治疗激素依赖型微小病变肾病临床疗效。方法选择微小病变肾病患者在足量激素治疗8-12周减量后出现激素依赖者,应用免疫抑制剂来氟米特联合小剂量激素,其中来氟米特片20mg,qd,po,联合小剂量激素泼尼松片30mg,qd,po。观察治疗1月后、2月后,6月后24h尿蛋白定量、血浆白蛋白、血脂(胆固醇TC,甘油三酯TG),血白细胞计数,肝功,肾功及水肿变化情况等指标变化,6个月后行疗效和安全性评价。结果来氟米特联合小剂量激素治疗半年后,多数患者未再复发,水肿症状消失或减轻,复查24h尿蛋白定量正常或减少,血白蛋白升高、血脂下降,肝肾功无明显异常,达到临床治愈或缓解。结论来氟米特联合小剂量激素治疗激素依赖型微小病变肾病临床效果明显,副反应较少。
Objective To observe the clinical efficacy of leflunomide combined with small dose of hormone therapy for hormone-dependent minimal change nephropathy. Methods Patients with minimal change nephropathy hormone-dependent after 8-12 weeks of adequate hormone therapy, the application of immunosuppressive leflunomide combined with small doses of hormones, including leflunomide tablets 20mg, qd, po, joint small Dosage hormone prednisone tablets 30mg, qd, po. Urine proteinuria, serum albumin, blood lipid (cholesterol TC, triglyceride TG), white blood cell count, changes of liver function, kidney function and edema were observed after 1 month, 2 months and 6 months of treatment. Efficacy and safety evaluation after 6 months. Results Leflunomide combined with small dose of hormone therapy six months later, the majority of patients no recurrence, edema disappeared or reduced, 24h urine protein normal quantitative or reduced, elevated serum albumin, decreased blood lipids, liver and kidney no obvious abnormalities, Reached clinical cure or remission. Conclusions Leflunomide combined with small dose of hormone treatment of hormone-dependent minimal change nephropathy clinical effect is obvious, fewer side effects.