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临床效果及对炎性细胞因子水平影响.docVIP

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临床效果及对炎性细胞因子水平影响 　　[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。 　　[关键词] 原发性难治性肾病综合征；来氟米特；泼尼松；炎性细胞因子 　　[中图分类号] R692.3#8195;#8195;#8195;[文献标识码] B#8195;#8195;#8195;[文章编号] 2095-0616（2014）11-77-04 　　 　　The observation of the effect and influence on inflammatory cytokine levels of Leflunomide and glucocorticoid in the treatment of patients with primary refractory nephrotic syndrome 　　WANG#8195;Liya 　　No.1 Department of Nephrology, the Central Hospital of Taian City in Shandong Province, Taian 271000, China 　　[Abstract] 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