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目的观察来氟米特联合泼尼松治疗难治性肾病综合征的临床效果。方法将60例难治性肾病综合征患者随机分为观察组与对照组各30例,观察组给予来氟米特联合泼尼松治疗,对照组给予环磷酰胺联合泼尼松治疗,比较2组的疗效及治疗前后24h尿蛋白定量、尿素氮、血肌酐的变化情况。结果观察组总有效率96.7%,对照组总有效率90.0%,2组疗效比较差异无统计学意义(P>0.05)。治疗前2组24h尿蛋白、尿素氮、血肌酐比较差异无统计学意义(P>0.05);治疗后2组患者的24h尿蛋白、尿素氮、血肌酐与治疗前比较均明显降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率为26.7%低于对照组的43.3%,但差异无统计学意义(P>0.05),2组患者耐受性均较好,无患者因不良反应而退出研究。结论来氟米特联合泼尼松治疗难治性肾病综合征疗效好,能改善患者的肾功能,值得推广和应用。
Objective To observe the clinical effect of leflunomide combined with prednisone in the treatment of refractory nephrotic syndrome. Methods Sixty patients with refractory nephrotic syndrome were randomly divided into observation group and control group, with 30 cases in each group. The observation group was given leflunomide combined with prednisone, and the control group was given cyclophosphamide combined with prednisone. Group curative effect and 24h urine protein, urea nitrogen, serum creatinine changes before and after treatment. Results The total effective rate was 96.7% in the observation group and 90.0% in the control group. There was no significant difference in the curative effect between the two groups (P> 0.05). There was no significant difference in 24h urine protein, urea nitrogen and serum creatinine between the two groups before treatment (P> 0.05). After 24 hours of treatment, urinary protein, urea nitrogen and serum creatinine in 24 hours were significantly lower than those before treatment Group were lower than the control group, the difference was statistically significant (P <0.05). The incidence of adverse reactions in the observation group was 26.7%, which was lower than that in the control group (43.3%), but the difference was not statistically significant (P> 0.05). The patients in both groups were well tolerated. No patients were withdrawn from the study due to adverse reactions. Conclusion Leflunomide combined with prednisone in the treatment of refractory nephrotic syndrome is effective and can improve the renal function of patients, it is worth promoting and application.