目的 探讨舒洛地特软胶囊联合来氟米特片治疗膜性肾病的临床疗效。方法 收集2015年5月-2017年5月在陕西省第四人民医院治疗的膜性肾病患者68例，根据用药的差别分为对照组（34例）和治疗组（34例）。对照组口服来氟米特片，前3 d 50 mg/次，1次/d，然后20 mg/次，1次/d维持治疗；治疗组在对照组的基础上口服舒洛地特软胶囊，250 LSU/次，2次/d。两组均经过4周治疗。评价两组患者临床疗效，同时比较治疗前后两组患者肾功能指标、血脂、血清白蛋白（ALB）和纤维蛋白原（FIB）水平以及血清学指标。结果 治疗后，对照组临床总有效率为64.71%，显著低于治疗组的82.35%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者24 h尿蛋白（24 h UTP）、血肌酐（Scr）、血尿素氮（BUN）、FIB、总胆固醇（TC）、三酰甘油（TG）水平均明显降低，ALB水平明显升高，同组比较差异具有统计学意义（P<0.05）；且治疗组患者上述指标改善程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清高流动性组蛋白-1（HMGB-1）、核转录因子-κB（NF-κB）、基质金属蛋白酶抑制因子-1（TIMP-1）和抗磷脂酶A2受体（PLA2R）水平均显著降低，同组比较差异具有统计学意义（P<0.05）；且治疗组患者血清学指标水平低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 舒洛地特软胶囊联合来氟米特片治疗膜性肾病可有效改善患者肾功能，降低血脂水平，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of sulodexide combined with leflunomide in treatment of membranous nephropathy. Methods Patients (68 cases) with membranous nephropathy in the Fourth People's Hospital of Shaanxi from May 2015 to May 2017 were divided into control (34 cases) and treatment (34 cases) groups according to different treatments. Patients in the control group were po administered with Leflunomide Tablets, 50 mg/time for the first 3 d, then 50 mg/time, once daily. Patients in the treatment group were po administered with Sulodexide Soft Capsules on the basis of the control group, 50 LSU/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the renal function indexes, serum lipids, but ALB and FIB levels, and serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 64.71%, which was significantly lower than 82.35% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the 24 h UTP, Scr, BUN, FIB, TC, and TG levels in two groups were significantly decreased, ALB levels were significantly increased, and there were differences in the same group (P<0.05). And these indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the HMGB-1, NF-κB, TIMP-1, anti-PLA2R levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Sulodexide combined with leflunomide can effectively improve renal function and reduce blood lipid levels in treatment of membranous nephropathy, which has a certain clinical application value.