CAJ | 학술논문

目的:了解来氟米特(LEF)、雷公藤多苷联合激素,以及单纯激素治疗IgA肾病的疗效.方法:回顾性分析不同方法治疗的中等量蛋白尿IgA肾病患者61例,其中来氟米特联合中等量激素(LEF组)21例,雷公藤多苷联合中等量激素(雷公藤多苷组)24例,单纯常规量激素治疗组16例.观察用药期间24 h尿蛋白定量、血尿素氮、血肌酐、血常规、血胆固醇、血清白蛋白、肝功能的变化,同时记录不良反应.结果:治疗24周后,LEF组的完全缓解率及总有效率分别为31.6%和84.2%,雷公藤多苷组的完全缓解率及总有效率分别为46.7%和86.7%,单纯激素组的完全缓解率及总有效率分别为46.7%和73.3%,3组疗效差异无统计学意义.治疗期间单纯激素组的复发率为20%,其他两组均为0,单纯激素治疗组复发率与LEF组、雷公藤多苷组相比差异有统计学意义.LEF组、雷公藤多苷组、单纯激素组的不良反应发生率分别为14.2%、37.5%、12.5%,雷公藤多苷组不良反应的发生率较其他两组显著高,差异有统计学意义.结论:LEF、雷公藤多苷联合激素和单纯激素治疗IgA肾病的近期疗效相似,但单纯激素治疗复发率高,雷公藤多苷治疗不良反应发生率高.3种治疗方法的长期疗效和安全性有待于进一步观察.
목적:료해래불미특(LEF)、뢰공등다감연합격소,이급단순격소치료IgA신병적료효.방법:회고성분석불동방법치료적중등량단백뇨IgA신병환자61례,기중래불미특연합중등량격소(LEF조)21례,뢰공등다감연합중등량격소(뢰공등다감조)24례,단순상규량격소치료조16례.관찰용약기간24 h뇨단백정량、혈뇨소담、혈기항、혈상규、혈담고순、혈청백단백、간공능적변화,동시기록불량반응.결과:치료24주후,LEF조적완전완해솔급총유효솔분별위31.6%화84.2%,뢰공등다감조적완전완해솔급총유효솔분별위46.7%화86.7%,단순격소조적완전완해솔급총유효솔분별위46.7%화73.3%,3조료효차이무통계학의의.치료기간단순격소조적복발솔위20%,기타량조균위0,단순격소치료조복발솔여LEF조、뢰공등다감조상비차이유통계학의의.LEF조、뢰공등다감조、단순격소조적불량반응발생솔분별위14.2%、37.5%、12.5%,뢰공등다감조불량반응적발생솔교기타량조현저고,차이유통계학의의.결론:LEF、뢰공등다감연합격소화단순격소치료IgA신병적근기료효상사,단단순격소치료복발솔고,뢰공등다감치료불량반응발생솔고.3충치료방법적장기료효화안전성유대우진일보관찰.
Objective: To Compare the clinical effects of Lefunomide combined with medium dose glucocorticoid, triptolide with medium dose glucocorticoid,and routine dose glucocorticoid for IgA nephropathy with medium albuminuria. Methods: Sixty-one patients with lgA nephropathy with medium albuminuria were respectively treated with Lefunomide combined with medium dose glucocorticoid, triptolide with medium dose glucocorticoid, and routine dose glucocorticoid. The clinical data were collected and evalu-ated before and in weeks 2,4,12 and 24 during the treatment. Results: The 24 h urinary protein excretion was decreased significantly in three sets after 24 weeks. The complete remission rate and total effective rate in LEF group was 31.6% ,84.2%, in triptolide group was 46.7% ,86.7%, in glucocorticoid group was 46.7% ,73.3% .There was no significant difference among the three sets.Recurrence rate in glucocorticoid group was 20% ,and those in other sets were 0. There was significant difference between LEF group and glucocorticoid group,and also between triptolide group and glucocorticoid group. Adverse effect rate in three sets respectively were 14.2 % ,37.5 %, 12.5%, and there was significant diffierence among LEF group and triptolide group, glucocorticoid group. Conclu-sion: Lefunomide combined with medium dose glucocorticoid and triptolide with medium dose glucocorticoid are also superior to rou-tine dose glucocorticoid in the treatment of IgA nephropathy with medium albuminuria. Adverse effect rate in LEF group is lower than it in triptolide group.