Objective To study the effects of combined leflunomide and cozaar therapy on IgA nephropathy. Methods Forty patients with IgA nephropathy diagnosed by renal biopsy were randomly divided into two groups: cozaar (100 mg/d) treated group and leflunomide(20mg/d) plus cozaar treated group. The changes in proteinuria and serum creatinine were observed. Results After 1 month treatment by the two methods, the level of proteinuria decreased significantly [(0.92±0.53) vs (1.28±0.99)](P <0.05)in all.After 3 and 6 months of treatment , the level of proteinuria in combined leflunomide and cozaar therapy group was lower than that in cozaar therapy group(P<0.05). Conclusions Combined leflunomide and cozaar therapy reduces 24 h urine proteinuria and protects renal function in patients with IgA nephropathy.
Key words
leflunomide /
cozaar /
IgA nephropathy
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1]刘洪涛,陈香美,汤力,等.尿激酶联合苯那普利治疗IgA肾病的随访对照研究[J].中华肾脏病杂志,2003,19(4):199-204.
[2]张馨,黎磊石,孙骅,等.不同类型IgA肾病的流行病学及临床特点分析[J].肾脏病与透析肾移植杂志,2006,15(4):305-309.
[3]张爱平,张磊,王艳侠,等.来氟米特治疗IgA肾病64例[J].中华肾脏病杂志,2004,20(3):176-177.
[4]张杰,何俊,李正良,等.来氟米特治疗 IgA肾病的临床研究[J].中国实用内科杂志,2005,25(7):628-630.
[5]傅鹏,于光,许静.来氟米特联合激素延缓进展型IgA肾病肾功能减退的临床研究[J].临床内科杂志,2006,23(11):731-733.
[6]张欣洲,何永成,罗琼,等.来氟米特治疗IgA肾病的多中心临床对照研究[J].中国实用内科杂志,2008,28(2):110-112 .
[7]Reich H N,Troyanov S,Scholey J W, et al.Remission of proteinuria improves prognosis in IgA Nephropathy[J]. J Am Soc Nephrol,2007,18(12):3177.
[8]石晓云,陈香美,刘述文,等.血管紧张素转换酶抑制剂对IgA肾病的疗效及影响因素分析[J].中华内科杂志,2002,41(6):399-402.
[9]Coppo R,Amore A,Gianoglio B,et al.Angiotensin Ⅱ local hyperreactivity in the progression of IgA nephropathy[J].Am J kidney Dis,1993,21:593-602.
[10]Cherwinski H M,Byars N. Leflunomide interferes with pyrimidine nucleotide biosynthesis[J]. Inflamm Res,1995,44(8):317.
[11]何雪晴,邢昌赢,庄凌,等.来氟米特对被动型Heymann肾炎大鼠肾组织WT-1表达的影响[J].江苏医药,2007,33(2):171-174.
[12]Pavenstadt H, Kriz W, Kretzler M.Cell biology of the glomerular podocyte[J].Physiol Rev,2003,83(1):253-307.
[13]Charles E P,Stewart F,Colin G M.Murine Denys- Drash syndrome: evi dence of podocyte de-differentiation and systemic mediation of glomerul- osclerosis[J].Human Molecular Genetics,2003,12 (18):2379 - 2394.
[14]Lou T,Wang C,Chen Z,et al.Randomised controlled trial of leflunomide in the treatment of immunoglobulin A nephropathy[J]. Nephrology , 2006,11(2):113.