来氟米特对育龄期女性狼疮性肾炎维持治疗的影响

目的 观察来氟米特（LEF）维持治疗育龄期女性狼疮性肾炎的效果.方法 将入组获诱导缓解育龄期女性狼疮性肾炎患者50例,随机分为来氟米特组（n=25）和环磷酰胺组（n=25）,来氟米特组每日口服来氟米特20mg,环磷酰胺组环磷酰胺1.0g＋生理盐水200ml静脉滴注,每3个月1次.两组均维持治疗12个月,连续观察12个月后,比较两组患者的临床疗效与不良反应.结果 来氟米特组复发率（16.0％）略高于环磷酰胺组（12.0％）,但无统计学差异（P=1.000）;总不良反应发生率无统计学差异（P＞0.05）,但来氟米特组停经率（4.0％）显著低于环磷酰胺组（32.0％,P=0.027）.结论 来氟米特较环磷酰胺更适用于育龄期女性狼疮性肾炎患者的长期维持治疗.

Maintenance treatment with leflunomide for lupus nephritis in female patients during child-bearing period

Objective To observe the clinical effect and safety of leflunomide in the maintenance therapy for lupus nephritis of female patients in child-bearing period. Methods 50 female patients of lupus nephrites in child-bearing period with a complete remission state after induction treatments were assigned randomly into leflunomide （LEF） group and cyclophosphamide （CTX） group. LEF group received leflunomide 20mg orally per day for 12 months, and CTX group received cyclophosphamide 1.0g＋saline 200ml intravenously 1 time for 3 month and lasted for 12 months. The therapeutic effect and adverse reaction were compared between the two groups. Results The recurrence rate and the total adverse reaction rate had no significant difference between LEF group （16.0%, 40. 0%） and CTX group （12.0%, 56.0%）, respectively, P=1. 000. However, the incidence of menelipsis in LEF group （4.0%） was less than that in CTX group （32.0%）, P=0. 027. Conclusion Compared with cyclophosphamide, leflunomide is more suitable for the maintenance treatment of lupus nephritis in female patients during child-bearing period.