论文部分内容阅读
目的通过对比观察小剂量糖皮质激素联合环孢霉素和来氟米特对原发性膜性肾病疗效。方法随机分为2组:试验组,激素+环孢霉素+来氟米特(醋酸强的松为0.5 mg·kg-1·d-1,环孢霉素为2～3 mg·kg-1·d-1,来氟米特为20 mg·d-1);对照组,醋酸强的松+环磷酰胺(醋酸强的松为0.5 mg·kg-1·d-1,环磷酰胺为12 mg·kg-1),每月1次;6次后,改为每3月1次;总量用至150 mg·kg-1。所有患者均予抗血小板及改善微循环治疗。随访时,观察血常规、尿常规、24 h尿蛋白定量、肝、肾功能。结果血清白蛋白上升水平及尿蛋白减少程度、缓解率,实验组优于对照组。结论小剂量糖皮质激素联合环孢霉素和来氟米特对原发性膜性肾病疗效优于传统的治疗方法,且安全有效。
Objective To compare the effects of low-dose glucocorticoid with cyclosporine and leflunomide on primary membranous nephropathy. Methods: Randomized divided into two groups: experimental group, hormone + cyclosporine + leflunomide (prednisone acetate 0.5 mg · kg-1 · d-1, cyclosporine 2 ~ 3 mg · kg- 1 · d-1 and leflunomide 20 mg · d-1). In the control group, prednisone + cyclophosphamide (prednisone acetate 0.5 mg · kg -1 · d -1, cyclophosphamide 12 mg · kg-1), once a month; after 6 times, changed to once every three months; the total amount to 150 mg · kg-1. All patients were anti-platelet and improve microcirculation. During follow-up, blood routine examination, urine routine examination, 24 h urine protein quantitation, liver and kidney function were observed. Results The level of serum albumin and the level of urinary protein reduction and remission rate were better in experimental group than in control group. Conclusion Low-dose glucocorticoids combined with cyclosporine and leflunomide are superior to traditional treatment for primary membranous nephropathy and are safe and effective.