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目的观察来氟米特与糖皮质激素治疗免疫球蛋白A(IgA)肾病的临床疗效及安全性。方法 60例IgA肾病患者分为试验组28例,对照组32例。对照组口服泼尼松0.5 mg·kg-1,2个月后每2周减少5 mg;试验组口服来氟米特20mg,每日2次,3 d后改为20 mg,每日1次。2组患者治疗周期均为3个月。比较2组患者治疗前后的24 h尿蛋白、肾小球滤过率及血清白蛋白变化及临床疗效。结果对照组与试验组的临床总有效率分别为53.13%和64.29%,差异无统计学意义(P>0.05);与治疗前相比,2组患者治疗后24 h尿蛋白明显降低,而肾小球滤过率及白蛋白明显升高(P<0.05);但治疗后上述指标组间比较差异无统计学意义(P<0.05);试验组与对照组不良反应发生率分别为21.43%和15.63%,差异无统计学意义(P>0.05)。结论来氟米特治疗IgA肾病安全有效,与糖皮质无明显差异。
Objective To observe the clinical efficacy and safety of leflunomide and glucocorticoid in the treatment of IgA nephropathy. Methods Sixty patients with IgA nephropathy were divided into experimental group (n = 28) and control group (n = 32). In the control group, prednisone was given 0.5 mg · kg-1 for 2 months and then decreased by 5 mg every 2 weeks. In the test group, leflunomide 20 mg orally twice daily for 3 days was changed to 20 mg once daily . The duration of treatment in both groups was 3 months. 24 h urinary protein, glomerular filtration rate, serum albumin and clinical efficacy of two groups before and after treatment were compared. Results The total effective rates of the control group and the experimental group were 53.13% and 64.29%, respectively. There was no significant difference between the two groups (P> 0.05) (P <0.05). However, there was no significant difference between the two groups after treatment (P <0.05). The incidences of adverse reactions in the experimental group and the control group were 21.43% and 15.63%, the difference was not statistically significant (P> 0.05). Conclusion Leflunomide treatment of IgA nephropathy safe and effective, and no significant difference between the glucocorticoid.