Objective: To explore effect of using leflunomide combined with hormone and hydroxychloroquine in treating clinical and subclinical lupus nephritis so to offer reference for its clinical treatment.Methods: Thirty two patients with clinical and subclinical lupus nephritis upon confirmed diagnosis were equally divided into Control Group and Treatment Group. Both groups were treated with deltacortisone 1mg per kg+ hydroxychloroquine 0.4g per day for 4-6 weeks. From then on, deltacortisone dose was reduced per week until 0.5mg/kg. Treatment Group was treated with leflunomide 10mg per day on the basis. Pleas observe both groups 12 weeks. Both were treated with low molecular heparin-weight anticoagulant therapy.Results: After treatment for 12 weeks, Treatment Group has an effective rate of 87.5% and Control Group 62.5%, showing a remarkable difference (P<0.05).Meanwhile, both groups showed no significant difference in 24hr urine protein quantitative and Alb before treatment. However, after treatment, 24hr urine protein quantitative dropped remarkably, with Treatment Group much lower than Control Group (P<0.05). Nevertheless, Alb rose dramatically, with Treatment Group much higher than Control Group (P<0.05).Conclusion: It is obvious to enhance curative effect with improved clinical symptom by using leflunomide combined with hormone and hydroxychloroquine in treating clinical and subclinical lupus nephritis. This is worth further researching.%目的:探讨来氟米特联合激素+羟氯喹在临床与亚临床狼疮性肾炎中治疗的效果,从而为其临床治疗提供参考.方法:32例确治临床与亚临床狼疮性肾炎患者平分为两组,2组均采用泼尼松1mg/kg+羟氯喹0.4/日治疗(4～6)周后,泼尼松此后每周减量5mg,直至0.5mg/g时维持.治疗组在此基础上加用来氟米特10mg/日.两组都观察12周.两组同时给予低分子肝素抗凝治疗.结果:治疗12周后,治疗组有效率为87.5%,对照组有效率为62,5%,治疗组的临床有效率明显高于对照组(P＜0.05).同时两组治疗前24h尿蛋白定量和Alb比较无显著性差异.治疗后24h尿蛋白定量明显下降,同时治疗组的下降幅度大于对照组(P<0.05).而Alb明显上升,治疗组的上升幅度也高于对照组(P<0.05).结论:来氟米特联合泼尼松+羟氯喹治疗临床与亚临床狼疮性肾炎明显提高疗效,改善临床症状,值得进一步深入研究.
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