摘要
目的比较来氟米特(leflunomide,LEF)与激素治疗IgA肾病的疗效和安全性。方法选取2004年4月至2005年10月深圳市人民医院、深圳市第二人民医院、北京大学深圳医院及广东医学院附属福田医院60例IgA肾病住院患者,将其分为LEF组36例和激素组24例,LEF组给予口服LEF20mg,每日2次,持续3d后改为每日1次,激素组给予口服泼尼松0.5mg/kg,8周后开始每2周减5mg。用药期间监测血压、24h尿蛋白定量、血尿素氮、血肌酐、血常规、肝功能、血清白蛋白、血尿酸、尿红细胞、平均动脉压等。12周后观察两组疗效和不良反应。结果治疗12周后,LEF组完全缓解率及总有效率分别为26.5%和50.0%,激素组完全缓解率及总有率分别为13.0%和65.2%。LEF组和MTX组不良反应发生率分别为27.8%和29.2%。两组疗效和不良反应发生率差异均无显著性意义(P>0.05)。激素组较LEF组起效快。结论LEF治疗IgA肾病疗效与泼尼松相似,且患者具有较好的耐受性,其长期疗效及安全性有待于进一步观察。
Objective To evaluate the efficacy and safety of leflunomide （ LEF ） in the treatment of IgA nephropathy. Methods From April 2004 to October 2005,60 patients with IgA nephropathy in four medical centers in Shenzhen were assigned randomly to two groups ： LEF group （ n = 36 ） , prednisone group （ n = 24 ）. Patients of LEF group were treated with LEF 20 mg once a day. Patients of prednisone group were treated with prednisone 0. 5 mg/kg,reduced 5 mg every 2 weeks after 8 weeks. Blood pressure,24 h urine protein,blood urea nitrogen,blood creatinine,blood routine,liver function, serum albumin,blood uric acid, urine erythrocyte and average arterial pressure were monitored. Efficacy and safety were e- valuated at 12 weeks after treatment. Results Complete remission rate was 26. 5% in LEF group and 13.0% in prednisone group;total response rate were 50. 0% and 65.2% , respectively. The incidence of side-effects were 27.8% and 29. 2%. The difference was not statistically significant（ P 〉 0.05 ）. Prednisone can act more quickly than LEF, After treat- ment blood pressure decreased significantly in LEF group（ P 〈 0. 05 ）. Conclusion LEF has the same effect as prednisone in the therapy of IgA nephropathy, and it was safe. The long-term efficacy and safety remains to be clarified.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2008年第2期110-112,共3页
Chinese Journal of Practical Internal Medicine
基金
深圳市科技局立项项目(200405007)
