目的 探討與評價潑尼松聯(lián)合來氟米特治療狼瘡性腎炎的臨床療效及其安全性。方法 2014年2月-2017年3月選擇在安陽市人民醫(yī)院診治的狼瘡性腎炎患者170例作為研究對象，根據(jù)入院順序隨機分為觀察組與對照組各85例，對照組給予潑尼松治療，觀察組在對照組治療的基礎上給予來氟米特治療，兩組都治療觀察4周。比較兩組治療后的臨床療效、血白蛋白、24 h尿蛋白定量、肌酐清除率及不良反應情況。結果 所有患者都順利完成治療，觀察組與對照組的治療總有效率分別為97.6%和88.2%，觀察組的治療總有效率明顯高于對照組，差異有統(tǒng)計學意義（P<0.05）。治療后觀察組的血白蛋白、24 h尿蛋白定量和肌酐清除率值分別（36.3±8.4） g/L、（1.9±0.8） g/24 h和（88.6±29.1） mL/min，對照組分別為（28.5±7.9） g/L、（2.8±1.7） g/24 h和（80.2±22.7） mL/min，各指標均較治療前顯著改善，組內差異有統(tǒng)計學意義（P<0.05）；同時治療后觀察組的血白蛋白和肌酐清除率顯著高于對照組，24 h尿蛋白定量顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）。治療期間觀察組的肝功能損傷、消化道癥狀、肺部感染等不良反應發(fā)生率為5.9%，對照組為7.1%，兩組對比差異無統(tǒng)計學意義。結論 潑尼松聯(lián)合來氟米特治療狼瘡性腎炎能改善患者的腎功能，提高治療效果，且不會增加不良反應的發(fā)生，有很好的應用價值。

Objective To investigate and evaluate the clinical efficacy and safety of prednisone combined with leflunomide in the treatment of chronic glomerulonephritis.Methods From February 2014 to March 2017, 170 cases of chronic glomerulonephritis patients in our hospital were selected as the research object, all the patients were randomly divided into observation group and control group with 85 cases in each group according to the order of admission, the control group was given prednisone treatment, the observation group was treated with prednisone combined with leflunomide, two groups were observed for 4 weeks.Results All the patients were completed the treatment successfully. The total effective rates in the observation group and the control group were 97.6% and 88.2% respectively, and the total effective rate in the observation group was significantly higher than that of the control group (P< 0.05). After treatment, serum albumin, 24 hours urinary protein and creatinine clearance value in the observation group were (36.3 ±8.4) g/L, (1.9 ±0.8) g/24 h and (88.6 ±29.1) mL/min, the control group were (28.5 ±7.9) g/L, (2.8 ±1.7) g/24 h and (80.2 ±22.7) mL/min respectively, which were significantly higher than before treatment (P< 0.05), at the same time after treatment, serum albumin and creatinine clearance value in the observation group were significantly higher than that of control group, 24 hours urinary protein quantitative significantly lower than the control group (P< 0.05). During the treatment period, the incidence rate of adverse reactions such as liver function injury, digestive tract symptom and pulmonary infection in the observation group was 5.9%, so that was 7.1% in the control group that compared was not significant difference between the two groups.Conclusion The prednisone combined with leflunomide in the treatment of chronic glomerulonephritis can improve the renal function of patients, improve the treatment effect, and will not increase the incidence of adverse reactions, so it has good application values.