[关键词]
[摘要]
目的 探讨与评价泼尼松联合来氟米特治疗狼疮性肾炎的临床疗效及其安全性。方法 2014年2月-2017年3月选择在安阳市人民医院诊治的狼疮性肾炎患者170例作为研究对象,根据入院顺序随机分为观察组与对照组各85例,对照组给予泼尼松治疗,观察组在对照组治疗的基础上给予来氟米特治疗,两组都治疗观察4周。比较两组治疗后的临床疗效、血白蛋白、24 h尿蛋白定量、肌酐清除率及不良反应情况。结果 所有患者都顺利完成治疗,观察组与对照组的治疗总有效率分别为97.6%和88.2%,观察组的治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后观察组的血白蛋白、24 h尿蛋白定量和肌酐清除率值分别(36.3±8.4) g/L、(1.9±0.8) g/24 h和(88.6±29.1) mL/min,对照组分别为(28.5±7.9) g/L、(2.8±1.7) g/24 h和(80.2±22.7) mL/min,各指标均较治疗前显著改善,组内差异有统计学意义(P<0.05);同时治疗后观察组的血白蛋白和肌酐清除率显著高于对照组,24 h尿蛋白定量显著低于对照组,差异有统计学意义(P<0.05)。治疗期间观察组的肝功能损伤、消化道症状、肺部感染等不良反应发生率为5.9%,对照组为7.1%,两组对比差异无统计学意义。结论 泼尼松联合来氟米特治疗狼疮性肾炎能改善患者的肾功能,提高治疗效果,且不会增加不良反应的发生,有很好的应用价值。
[Key word]
[Abstract]
Objective To investigate and evaluate the clinical efficacy and safety of prednisone combined with leflunomide in the treatment of chronic glomerulonephritis.Methods From February 2014 to March 2017, 170 cases of chronic glomerulonephritis patients in our hospital were selected as the research object, all the patients were randomly divided into observation group and control group with 85 cases in each group according to the order of admission, the control group was given prednisone treatment, the observation group was treated with prednisone combined with leflunomide, two groups were observed for 4 weeks.Results All the patients were completed the treatment successfully. The total effective rates in the observation group and the control group were 97.6% and 88.2% respectively, and the total effective rate in the observation group was significantly higher than that of the control group (P< 0.05). After treatment, serum albumin, 24 hours urinary protein and creatinine clearance value in the observation group were (36.3 ±8.4) g/L, (1.9 ±0.8) g/24 h and (88.6 ±29.1) mL/min, the control group were (28.5 ±7.9) g/L, (2.8 ±1.7) g/24 h and (80.2 ±22.7) mL/min respectively, which were significantly higher than before treatment (P< 0.05), at the same time after treatment, serum albumin and creatinine clearance value in the observation group were significantly higher than that of control group, 24 hours urinary protein quantitative significantly lower than the control group (P< 0.05). During the treatment period, the incidence rate of adverse reactions such as liver function injury, digestive tract symptom and pulmonary infection in the observation group was 5.9%, so that was 7.1% in the control group that compared was not significant difference between the two groups.Conclusion The prednisone combined with leflunomide in the treatment of chronic glomerulonephritis can improve the renal function of patients, improve the treatment effect, and will not increase the incidence of adverse reactions, so it has good application values.
[中图分类号]
[基金项目]