中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
5期
853-857
,共5页
狼疮肾炎%治疗结果%来氟米特%吗替麦考酚酯
狼瘡腎炎%治療結果%來氟米特%嗎替麥攷酚酯
랑창신염%치료결과%래불미특%마체맥고분지
Lupus nephritis%Treatment outcome%Leflunomide%Mycophenolate mofetil
目的：观察来氟米特联合吗替麦考酚酯治疗狼疮性肾炎的临床疗效。方法选择辽宁医学院附属第一医院2011年4月至2013年4月风湿免疫科住院的狼疮性肾炎的患者100例，随机分为治疗组和对照组，每组各50例，治疗组给予来氟米特联合吗替麦考酚酯治疗，对照组只采用环磷酰胺冲击治疗，疗程均为9个月。用药前常规测1次血常规、尿常规、24 h尿蛋白定量，血生化系列（肝、肾功能、血脂、血浆蛋白、肌酶），免疫学指标[抗核抗体（ANA）、抗双链DNA（ds-DNA）抗体、补体C3、补体C4]。用药半个月后复查以上指标，此后每1个月测1次以上指标。结果治疗组的血浆白蛋白、补体C3、C4较治疗前明显上升，组间比较差异有统计学意义（P＜0.05），血肌酐（Scr）、尿素氮（BUN）、24 h尿蛋白总量、系统性红斑狼疮疾病活动度评分（SLEDAI）评分较治疗前明显下降，组间比较差异有统计学意义（P＜0.05），联合治疗组的ANA阳性率、抗ds-DNA抗体阳性率治疗后明显下降，组间比较差异有统计学意义（P＜0.05）。两组不良反应比较差异无统计学意义（P＞0.05）。结论来氟米特联合吗替麦考酚酯治疗狼疮性肾炎的疗效明显优于单独环磷酰胺冲击治疗，且不良反应不增加。
目的：觀察來氟米特聯閤嗎替麥攷酚酯治療狼瘡性腎炎的臨床療效。方法選擇遼寧醫學院附屬第一醫院2011年4月至2013年4月風濕免疫科住院的狼瘡性腎炎的患者100例，隨機分為治療組和對照組，每組各50例，治療組給予來氟米特聯閤嗎替麥攷酚酯治療，對照組隻採用環燐酰胺遲擊治療，療程均為9箇月。用藥前常規測1次血常規、尿常規、24 h尿蛋白定量，血生化繫列（肝、腎功能、血脂、血漿蛋白、肌酶），免疫學指標[抗覈抗體（ANA）、抗雙鏈DNA（ds-DNA）抗體、補體C3、補體C4]。用藥半箇月後複查以上指標，此後每1箇月測1次以上指標。結果治療組的血漿白蛋白、補體C3、C4較治療前明顯上升，組間比較差異有統計學意義（P＜0.05），血肌酐（Scr）、尿素氮（BUN）、24 h尿蛋白總量、繫統性紅斑狼瘡疾病活動度評分（SLEDAI）評分較治療前明顯下降，組間比較差異有統計學意義（P＜0.05），聯閤治療組的ANA暘性率、抗ds-DNA抗體暘性率治療後明顯下降，組間比較差異有統計學意義（P＜0.05）。兩組不良反應比較差異無統計學意義（P＞0.05）。結論來氟米特聯閤嗎替麥攷酚酯治療狼瘡性腎炎的療效明顯優于單獨環燐酰胺遲擊治療，且不良反應不增加。
목적：관찰래불미특연합마체맥고분지치료랑창성신염적림상료효。방법선택료녕의학원부속제일의원2011년4월지2013년4월풍습면역과주원적랑창성신염적환자100례，수궤분위치료조화대조조，매조각50례，치료조급여래불미특연합마체맥고분지치료，대조조지채용배린선알충격치료，료정균위9개월。용약전상규측1차혈상규、뇨상규、24 h뇨단백정량，혈생화계렬（간、신공능、혈지、혈장단백、기매），면역학지표[항핵항체（ANA）、항쌍련DNA（ds-DNA）항체、보체C3、보체C4]。용약반개월후복사이상지표，차후매1개월측1차이상지표。결과치료조적혈장백단백、보체C3、C4교치료전명현상승，조간비교차이유통계학의의（P＜0.05），혈기항（Scr）、뇨소담（BUN）、24 h뇨단백총량、계통성홍반랑창질병활동도평분（SLEDAI）평분교치료전명현하강，조간비교차이유통계학의의（P＜0.05），연합치료조적ANA양성솔、항ds-DNA항체양성솔치료후명현하강，조간비교차이유통계학의의（P＜0.05）。량조불량반응비교차이무통계학의의（P＞0.05）。결론래불미특연합마체맥고분지치료랑창성신염적료효명현우우단독배린선알충격치료，차불량반응불증가。
Objective To investigate and analyze the clinic effect of leflunomide (LEF) combined with mycophenolate mofetil (MMF) on lupus nephritis. Methods From April 2011 to April 2013, 100 cases of lupus nephritis patients treated in our hospital were choosed, and they were randomly divided into the treatment group and control group, 50 cases of each group. The treatment group was treated with LEF and MMF, the control group were treated with CTX for 9 months. Before medication routine measure blood routine, urine routine, 24 h urinary protein, blood biochemical series (liver function, renal function, blood lipid, plasma protein, muscle enzymes), immunological indexes (ANA, anti ds-DNA, complement C3, complement C4). After half a month, review above indexes, and measure above indexes per month. Results The serum album, complement factor C3, C4 were significantly increased in treatment group, there was significant difference between the two groups (P<0.05). Cr, BUN, 24 h total urinary protein, SLEDAI scores were lower after treatment, there was a significant statistic difference between the groups (P<0.05). The treatment group ANA positive rate, the positive rate of anti ds-DNA antibody decreased significantly after treatment, and there was a significant statistic difference between the groups (P<0.05). There was no significant difference between the two groups of adverse effect (P>0.05). Conclusion The clinic effect of LEF combined with MMF on lupus nephritis is obviously better than the single application of CTX, and the adverse effect does not increased.
