目的 探討他克莫司和來(lái)氟米特治療難治性腎病綜合征的臨床療效。方法 選取2014年2月—2015年2月在鄭州大學(xué)第一附屬醫(yī)院接受治療的難治性腎病綜合征患者76例，隨機(jī)分為對(duì)照組（38例）和治療組（38例）。對(duì)照組患者口服來(lái)氟米特片，50 mg/d，連續(xù)服用3 d后改為20 mg/d維持治療；治療組患者口服他克莫司膠囊，0.05 mg/(kg·d)，保持血藥濃度在10 ng/mL。兩組患者均連續(xù)治療6個(gè)月。比較兩組患者治療前后臨床療效和觀察指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為76.32%、94.74%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組患者24 h尿蛋白定量（24 h Pro）、血肌酐（Scr）、血尿素氮（BUN）和三酰甘油水平均明顯低于同組治療前，血清白蛋白水平明顯升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組這些觀察指標(biāo)優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。結(jié)論 他克莫司治療難治性腎病綜合征的臨床效果好，有利于患者腎功能改善，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy between tacrolimus and leflunomide in treatment of refractory nephrotic syndrome. Methods Patients (76 cases) with refractory nephrotic syndrome in the First Affiliated Hospital of Zhengzhou University from February 2014 to February 2015 were divided into control (38 cases) and treatment (38 cases) groups. Patients in the control group were po administered with Leflunomide Tablets, 50 mg/time, and then 20 mg/time for maintenance treatment after treatment for 3 d. Patients in the treatment group were po administered with Tacrolimus Capsules, 0.05 mg/(kg·d), and kept blood concentration in 10 ng/mL. Patients in two groups were treated for six months. After treatment, the clinical efficacy, observation indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.32% and 94.74% respectively, and there was difference between two groups (P < 0.05). After treatment, the 24 h Pro, Scr, BUN, and TG levels in two groups significantly decreased, but the serum albumin significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Tacrolimus has good clinical effect in treatment of refractory nephrotic syndrome, which is conducive to the improvement of renal function and has a certain clinical application value.