中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2009年
6期
550-552
,共3页
洪建东%施丽景%郑天文%苏志强%付清流
洪建東%施麗景%鄭天文%囌誌彊%付清流
홍건동%시려경%정천문%소지강%부청류
肾病综合征%急性链球菌感染%肾小球肾炎%糖皮质激素%儿童
腎病綜閤徵%急性鏈毬菌感染%腎小毬腎炎%糖皮質激素%兒童
신병종합정%급성련구균감염%신소구신염%당피질격소%인동
Nephrotic syndrome%Acute nephritis%Streptococcal infection%Glucocorticoids%Children
目的 探讨糖皮质激素对儿童急性链球菌感染后肾炎(PSAGN)致肾病综合征(NS)的治疗作用.方法 采取开放对照研究的方法对63例呈NS表现的儿童PSAGN在常规治疗的基础上给予标淮中长程的泼尼松治疗.治疗结果与常规治疗组进行对比.结果 激素组治疗6个月末95.2%(60/63)尿蛋白阴转,12个月末100%(63/63)阴转;常规组在相同时期尿蛋白阴转率分别为74%(37/50)和80%(40/50).激素组治疗12个月末95.2%(60/63)镜下血尿消失,18个月末100%(63/63)消失;常规组在相同时期镜下血尿消失率分别为72%(36/50)和84%(42/50).激素组治疗2个月末血压恢复正常为92.1%(35/38),3个月末为100%(38/38);常规组在相同时期血压恢复正常分别为72.7%(24/33)和84.8%(28/33).激素组治疗1个月末肾功能恢复正常为91.7%(11/12),2个月末为100%(12/12);常规组在相同时期分别为42.9%(3/7)和57.1%(4/7).两组的上述治疗效果差异有显著性(P＜0.05或P＜0.01).结论 对PSAGN致NS患儿使用糖皮质激素治疗可有效减少尿蛋白及镜下血尿,促使肾功能、血压较快恢复,改善预后,减少肾脏慢性病变.
目的 探討糖皮質激素對兒童急性鏈毬菌感染後腎炎(PSAGN)緻腎病綜閤徵(NS)的治療作用.方法 採取開放對照研究的方法對63例呈NS錶現的兒童PSAGN在常規治療的基礎上給予標淮中長程的潑尼鬆治療.治療結果與常規治療組進行對比.結果 激素組治療6箇月末95.2%(60/63)尿蛋白陰轉,12箇月末100%(63/63)陰轉;常規組在相同時期尿蛋白陰轉率分彆為74%(37/50)和80%(40/50).激素組治療12箇月末95.2%(60/63)鏡下血尿消失,18箇月末100%(63/63)消失;常規組在相同時期鏡下血尿消失率分彆為72%(36/50)和84%(42/50).激素組治療2箇月末血壓恢複正常為92.1%(35/38),3箇月末為100%(38/38);常規組在相同時期血壓恢複正常分彆為72.7%(24/33)和84.8%(28/33).激素組治療1箇月末腎功能恢複正常為91.7%(11/12),2箇月末為100%(12/12);常規組在相同時期分彆為42.9%(3/7)和57.1%(4/7).兩組的上述治療效果差異有顯著性(P＜0.05或P＜0.01).結論 對PSAGN緻NS患兒使用糖皮質激素治療可有效減少尿蛋白及鏡下血尿,促使腎功能、血壓較快恢複,改善預後,減少腎髒慢性病變.
목적 탐토당피질격소대인동급성련구균감염후신염(PSAGN)치신병종합정(NS)적치료작용.방법 채취개방대조연구적방법대63례정NS표현적인동PSAGN재상규치료적기출상급여표회중장정적발니송치료.치료결과여상규치료조진행대비.결과 격소조치료6개월말95.2%(60/63)뇨단백음전,12개월말100%(63/63)음전;상규조재상동시기뇨단백음전솔분별위74%(37/50)화80%(40/50).격소조치료12개월말95.2%(60/63)경하혈뇨소실,18개월말100%(63/63)소실;상규조재상동시기경하혈뇨소실솔분별위72%(36/50)화84%(42/50).격소조치료2개월말혈압회복정상위92.1%(35/38),3개월말위100%(38/38);상규조재상동시기혈압회복정상분별위72.7%(24/33)화84.8%(28/33).격소조치료1개월말신공능회복정상위91.7%(11/12),2개월말위100%(12/12);상규조재상동시기분별위42.9%(3/7)화57.1%(4/7).량조적상술치료효과차이유현저성(P＜0.05혹P＜0.01).결론 대PSAGN치NS환인사용당피질격소치료가유효감소뇨단백급경하혈뇨,촉사신공능、혈압교쾌회복,개선예후,감소신장만성병변.
Objective To investigate the effects of glucocorticoids (GC) on the nephrotic syndrome (NS) caused by acute nephritis after streptococcal infection (PSAGN) in children. Methods Sixty-three children with the NS caused by PSAGN were studied controlly, all of them were administrated with standard long-term prednisone treatment based on the conventional treatment. The treatment outcome was compared with that of the conventional treatment group. Results 95. 2% (60/63) of patients in the GC group, the urinary protein became negative at the end of six months, 100% (63/63) negative at the end of twelve months.And in the conventional group the negative rates were 74% (37/50) and 80% (40/50) respectively at the same time. 95. 2% ( 60/63 ) of patients in the GC group microscopic hematuria disappeared at the end of twelve months, 100% (63/63) disappeared at the end of eighteen months. And in the conventional group the disappearance rates were 72% (36/50) and 84% (42/50) respectively at the same time. 92. 1 % (35/38)of patients in the GC group blood pressure returned to normal at the end of two months, 100% (38/38) normal at the end of three months. And in the conventional group the normal rates were 72.7% (24/33) and 84. 8% (28/33) respectively at the same time. 91. 7% (11/12) of patients in the GC group showed normal renal function at the end of one month, 100% (12/12) normal at the end of two months. And in the conventional group the normal rates were 42. 9% (3/7) and 57. 1% (12/12) at the same time. There were significant differences in the outcomes between the two groups( P ＜ 0.05 or P ＜ 0. 01). Conclusion With the useof GC for the NS caused by PSAGN in children.it can effectively reduce the duration of urinary protein and microscopic hematuria,and promote rapid recovery of renal function and blood pressure,thereby improving the prognosis.
