临床研究

原发性肾病综合征的临床治疗分析与前瞻性研究

郭冬慈1 荣阳2 荣根满3

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【摘要】  【摘要】目的 研究分析甲基强的松龙治疗原发性肾病综合征的疗效和不良反应与临床意义。方法 对治疗组48例患者予每日静滴甲基强的松龙40 mg或80 mg,2周后改为强的松1 mg/(kg•d),口服;对照组48例予强的松1 mg/(kg•d),顿服。

【关键字】  原发性肾病综合征,甲基强的松龙,临床疗效

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[Abstract] Objective To study the efficacy, side effects and clinical significance of methylprednisolone in the treatment of primary nephrotic syndrome. Methods Forty-eight patients in the treatment group were given daily infusion of methylprednisolone 40 mg or 80 mg, 2 weeks later, prednisone 1 mg/(kg•d), orally; 48 patients in the control group were given prednisone. 1 mg/(kg•d), served. Results The treatment group was significantly better than the control group in terms of urinary protein conversion time, average hospitalization time and plasma albumin recovery time. The incidence of adverse reactions such as sodium retention, liver damage and nosocomial infection was lower than that of the control group. Conclusion Methylprednisolone is a safe and effective treatment for the treatment of primary nephrotic syndrome with rapid onset, good curative effect and less adverse reactions.

原发性肾病综合征(NS)是一类常见的肾小球疾病,其主要机制为免疫介导,糖皮质激素为主要的治疗药物[1]。本研究发现,甲基强的松龙(甲泼尼松琥珀酸钠MP)在治疗原发性肾病综合征中,具有明显缩短起效时间、迅速缓解病情及不良反应少的特点,报道如下。 1 资料与方法 1.1 一般资料:选择2015年1月至2018年9月,本院收治的96例住院患者均符合肾病综合征的临床诊断标准[2]:①大量蛋白尿(≥3.5 g/d);②低清蛋白血症(≤30 g/L);③明显水肿;④高脂血症,其中①、②项必备。所有病例均排除继发性肾小球疾病,并行肾穿刺活检确定病理类型为微小病变(MCN)或轻度系膜增生性肾小球肾炎(MsPGN)。随机分为甲基强的松龙组(治疗组)和强的松组(对照组)。治疗组48例,男26例,女22例;年龄15~70岁,平均(32.2±17.3)岁。对照组48例,男20例,女28例;年龄16~75岁,平均(33.3±18.5)岁。两组患者的性别、年龄、病情及病理类型方面比较,差异无统计学意义(P>0.05)。 1.2 治疗方法 1.2.1 一般治疗:所有患者均低盐低脂优质蛋白饮食、利尿消肿、降脂、降压及抗血小板聚集等治疗。 1.2.2 对照组:予强的松治疗,剂量为l mg/(kg•d),晨起顿服,最大剂量为60 mg,疗程8~12周,以后按常规方法减量。

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