目的：探讨来氟米特联合雷公藤多甙及小剂量泼尼松治疗中老年难治性肾病综合征的临床效果。方法选择60例中老年难治性肾病综合征患者，按就诊单双序号半随机分为治疗组32例和对照组28例。治疗组给予来氟米特联合雷公藤多甙及小剂量泼尼松治疗，对照组给予环磷酰胺（ CTX）联合泼尼松治疗，比较两组的临床疗效、生化指标变化以及不良反应发生情况。结果治疗组临床疗效显著高于对照组（P＜0.05），治疗后3个月、6个月与对照组同期血红蛋白、尿蛋白、血浆白蛋白、血肌酐检测值比较差异均有统计学意义（P＜0.05）；治疗组不良反应发生率低于对照组（P＜0.05）。结论来氟米特联合雷公藤多甙及小剂量泼尼松治疗中老年难治性肾病综合征效果确切，且安全性高。%Objective To investigate the clinical effects of leflunomide combined with tripterygium glyco-sides and low-dose prednisone in the treatment of refractory nephrotic syndrome in middle and elderly patients .Meth-ods Sixty patients with refractory nephrotic syndrome treated in the affiliated hospital of Xuzhou medical college were chosen as the research object .They were randomly divided into the treatment group with of 32 patients and the control group with 28 patients.The treatment group was treated with leflunomide combined with Tripterygium glycosides and low-dose prednison and the control group was treated with cyclophosphamide ( CTX ) and prednisone .The clinical effects changes in biochemical markers and the incidence rate reactions between the two groups were compared .Re-sults After treatment,the total effective rate 81.25% in the treatment group was significantly higher than the total effective rate(67.86%) in the control group(P<0.05).After treatment for 3 months or 6 months,there were statisti-cally significant differences in the levels of hemoglobin ,urine protein,serum albumin,serum creatinine between two groups(P<0.05).The incidence rate of adverse reactions (9.38%) in the treatment group was significantly lower than that(35.71%) in the control group(P<0.05).Conclusion The effect of leflunomide combined with triptery-gium glycosides and low-dose prednisone in the treatment of refractory nephrotic syndrome in the middle and elderly patients is exact and safe .
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