摘要
目的观察来氟米特联合糖皮质激素治疗原发性难治性肾病综合征患者的临床效果及对炎性细胞因子水平的影响，指导临床合理治疗。方法选择我院2011年3月～2013年11月收治的60例原发性难治性肾病综合征作为试验对象，按治疗方法差异随机分为观察组30例和对照组30例，对照组给予泼尼松标准疗程治疗，1mg/（kg·d），连用12周，观察组在对照组的基础上再给予来氟米特，起始剂量为50mg／d顿服，服用3d后减量至20mg／d顿服，连用12周，治疗前后检测血清总蛋白、血清白蛋白、尿蛋白及。肾功能指标，采用酶联免疫吸附试验（ELISA）检测治疗前后IL-8、TNF—α水平，评判两组临床疗效。结果（1）观察组和对照组治疗后尿蛋白、尿素氮、血肌酐明显低于治疗前（均P〈0．05），观察组治疗后尿蛋白、尿素氮、血肌酐明显低于对照组（均p〈0．05）；（2）观察组和对照组治疗后血清总蛋白、血清白蛋白明显高于治疗前（均P〈0．05），观察组血清总蛋白、血清白蛋白明显高于对照组（均P〈0．05）；（3）观察组和对照组治疗后IL-8、TNF-α明显低于治疗前（均P〈0．05），观察组治疗后IL-8、TNF-α明显低于对照组（均P〈0．05）；（4）观察组的临床总有效率明显高于对照组（P〈0．01）。结论来氟米特联合糖皮质激素治疗原发性难治性肾病综合征患者的临床疗效确切，能够有效调节炎性细胞因子水平，抑制肾病炎症反应，从而改善肾功能、降低尿蛋白、升高血清蛋白，抑制疾病进展，临床疗效明显提高，值得临床推广使用。
Objective To observe the effect and influence on inflammatory cytokine levels of Leflunomide and glucocorticoid in the treatment of patients with Primary refractory nephrotic syndrome, and guide rational treatment for clinic. Methods 60 patients with Primary refractory nephrotic syndrome from March 2011 to November 2013 were selected as the test object, all the patients were randomly divided into 30 case of observation group and 30 case of control group according to different treatment, the control group had been given prednisone for 12 weeks, 1mg/（kg· d）, The observation group were given leflunomide for 12 weeks on basis of the control group, starting dose 50mg/d, after 3d, reducted to 20mg/d, the total serum protein, serum albumin, urine protein and renal function were detected before and after treatment, IL-8 and TNF-a were detected by ELISA, evaluated the clinical efficacy. Results （1）The urinary protein, blood urea nitrogen, serum creatinine of observation group and control group after treatment were significantly lower than before treatment（all P 〈 0.05）, the urinary protein, blood urea nitrogen, serum creatinine of observation group ware significantly lower after treatment than the control group（P 〈 0.05）; （2）serum total protein and serum albumin of observation group and control group after treatment were significantly higher than before treatment （all P 〈 0.05）, serum total protein and serum albumin of observation group were significantly higher than control group（all P 〈 0.05）; （3）IL-8 and TNF-α of observation group and control group after treatment were significantly lower than before treatment（all P 〈 0.05）; IL-8 and TNF-α of observation group after treatment were significantly lower than control group（all P 〈 0.05）;（4）the total clinical efficiency of observation group was significantly higher than control group（all P 〈 0.01）. Conclusion The method containing leflunomide and glucocorticoid can effectively regulate inflammatory cytokines, inhibit kidney inflammation, then Improve renal function and reduce proteinuria,elevated serum protein, inhibit disease progression, significantly improved clinical efficacy, worthy of clinical use in the treatment of patients with Primary refractory nephrotic syndrome.
出处
《中国医药科学》
2014年第11期77-79,88,共4页
China Medicine And Pharmacy
