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目的:观察醋酸泼尼松联合来氟米特治疗免疫球蛋白A(IgA)肾病的疗效及安全性。方法:选取IgA肾病患者80例,按随机数字表法分为观察组和对照组,各40例。对照组患者给予醋酸泼尼松1.0 mg/kg,qd,6周后逐渐减量,至12周时降至0.5 mg/kg;观察组患者在对照组基础上加用来氟米特50 mg,qd,3 d后降至20 mg。两组患者均治疗3个月。观察两组患者治疗后临床疗效及24 h尿蛋白定量、血肌酐(SCr)、血尿素氮(BUN)水平,并记录治疗过程中的不良反应情况。结果:观察组患者总有效率(95.0%)显著高于对照组(75.0%),差异有统计学意义(P<0.05);治疗后,两组患者的24 h尿蛋白定量、SCr、BUN水平均显著降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组患者的不良反应发生率(0)显著低于对照组(7.5%),差异有统计学意义(P<0.05)。结论:醋酸泼尼松联合来氟米特治疗IgA肾病患者效果显著,且不会增加患者的不良反应。
Objective: To observe the efficacy and safety of prednisone acetate combined with leflunomide in the treatment of IgA nephropathy. Methods: Eighty IgA nephropathy patients were randomly divided into observation group and control group according to random number table method, 40 cases in each group. Control group patients given prednisone acetate 1.0 mg / kg, qd, 6 weeks after the gradual reduction to 12 weeks to 0.5 mg / kg; observation group patients in the control group based on the addition of leflunomide 50 mg, qd, dropped to 20 mg after 3 days. Two groups of patients were treated for 3 months. The clinical curative effect and 24 h urinary protein quantitation, serum creatinine (SCr) and blood urea nitrogen (BUN) levels were observed after treatment in both groups. The adverse reactions during the treatment were recorded. Results: The total effective rate (95.0%) in the observation group was significantly higher than that in the control group (75.0%), the difference was statistically significant (P <0.05); after treatment, 24 h urinary protein, SCr and BUN Were significantly lower, and the observation group was lower than the control group, the difference was statistically significant (P <0.05). The incidence of adverse reactions in observation group (0) was significantly lower than that in control group (7.5%), the difference was statistically significant (P <0.05). Conclusion: Prednisone acetate combined with leflunomide treatment of patients with IgA nephropathy significant effect, and does not increase the adverse reactions in patients.