CAJ | 학술논문

目的探讨小剂量多巴胺联用等量酚妥拉明对原发性肾病综合征(PNS)患儿水肿的疗效及安全性.方法采取回顾性对照研究的方法.在常规综合治疗的基础上,对155例PNS并发水肿患儿(联用治疗组)给予小剂量多巴胺联用等量酚妥拉明治疗,并与128例单用呋塞米患儿(呋塞米治疗组)对照.结果联用治疗组治疗后尿量、尿钠均高于治疗前,差异有显著性(P＜0.01),而血钾、血钠及尿钾虽高于治疗前,但差异无显著性(P＞0.05).呋塞米治疗组治疗后尿量、尿钾、尿钠均高于治疗前,差异有显著性(P＜0.01),而血钾、血钠均低于治疗前,差异有显著性(P＜0.01).联用治疗组治疗后水肿减轻率、尿量、尿钠、血钾及血钠均高于呋塞米治疗组,差异有显著性(P＜0.01);而尿钾低于呋塞米治疗组,差异有显著性(P＜0.05).治疗后药物不良反应发生率方面,联用治疗组低于呋塞米治疗组,差异有显著性(P＜0.01).结论小剂量多巴胺联用等量酚妥拉明治疗小儿PNS水肿安全、有效,适用于不同血容量状态的患儿,可替代呋塞米等利尿剂作为一线用药.
목적 탐토소제량다파알련용등량분타랍명대원발성신병종합정(PNS)환인수종적료효급안전성.방법 채취회고성대조연구적방법.재상규종합치료적기출상,대155례PNS병발수종환인(련용치료조)급여소제량다파알련용등량분타랍명치료,병여128례단용부새미환인(부새미치료조)대조.결과 련용치료조치료후뇨량、뇨납균고우치료전,차이유현저성(P＜0.01),이혈갑、혈납급뇨갑수고우치료전,단차이무현저성(P＞0.05).부새미치료조치료후뇨량、뇨갑、뇨납균고우치료전,차이유현저성(P＜0.01),이혈갑、혈납균저우치료전,차이유현저성(P＜0.01).련용치료조치료후수종감경솔、뇨량、뇨납、혈갑급혈납균고우부새미치료조,차이유현저성(P＜0.01);이뇨갑저우부새미치료조,차이유현저성(P＜0.05).치료후약물불량반응발생솔방면,련용치료조저우부새미치료조,차이유현저성(P＜0.01).결론 소제량다파알련용등량분타랍명치료소인PNS수종안전、유효,괄용우불동혈용량상태적환인,가체대부새미등이뇨제작위일선용약.
Objective To explore the efficacy and safety of low dose dopamine combined with phentolamine in the treatment of primary nephrotic syndrome (PNS) with edema. Methods Retrospective control studies were performed in 155 patients of PNS with edema, who received comprehensive treatment with small dose dopamine combined with phentolamine (group A). Patients treated with furosemide infusion were recruited as control (group B). Results The urinary output, urinary sodium increased after therapy in group A, showing significant differences (P ＜ 0. 01). But urinary potassium excretion, serum sodium and potassium showed no significant difference after therapy in group A. The urinary output, urinary sodium and potassium excretion increased and the serum sodium and potassium decreased after therapy in group B, all showing significant differences between before and after treatment (P ＜0. 01). The edema relief rate,urinary output, urinary sodium excretion, serum sodium and potassium in group A was significantly higher whereas urinary potassium excretion were significantly lower than those of group B(P ＜0. 01). The rate of drug adverse reaction in group A was significantly lower than that of group B. Conclusion Low dose dopamine combined with phentolamine in PNS with edema is safe and effective,which may be a substitute of diuretic like furosemide in the treatment of edema of patients with different blood volume.