激素不同疗法治疗小儿原发性肾病综合征

The different therapy of corticosteroid for children's primary nephrotic syndrome

研究目的肾上腺皮质激素是诱导肾病综合征(PNS)缓解的首选药物,但因需大剂量,长疗程,可发生不同程度的合并症。本研究旨在比较不同激素治疗方法,筛选出疗效好、副作用少的给药方法。研究方法 122例PNS患儿随机分为3组,分别按qd、qod和分次疗法施以激素后,劝态观察临床症状、尿蛋白和血液生化检测及副作用等指标,统计学处理采用卡方检验。研究结果qd、qod、分次疗法组有效率分别为97.62％、97.5％、97.5％,三组近期疗效比较无显著性差异(P>0.05);水肿消退时间及尿蛋白消失时间qod组(分别为17.57±11.1天,46.14±17.8天)较qd组(10.08±7.0天,21.89±15.49天)和分次疗法组(11.47±14.68天,21.62±16.32天)长(P<0.05),后两组比较无显著性差异(P>0.05)。3组疗法激素副作用比较有显著性差异(P<0.01),分次疗法组发生率最高,qd组较低,qod组最低。结论对小儿PNS首始治疗应采用每日凌晨顿服法。

Objective The corticosteroid is the first——se-letted medicine for patien ts with nephriticsyndrome f NS).Because of a large dosage andlong course is needed in the treatment withcorticosteroid.the therapeutic complications mayappear in varied degrees.‘Fhe different therapy ofcorticosteroid were compared and studied.Thestudy purpose was selecting a reasonable therapywith better effect and less side—effects. Methods I 22 patients with primarynephritic syndrome(PNS)were randomly di-vided into three groups that were givencorticosteroid with qd,qod,fractional therapy、respectively.After treatment。the clinical syrup—toms,urinary protein,blood biochemical test andside-effects were observed in dynamically.The re—sults were handled with Chi～square test. Results The short-term effects of threegroups hadn’t difference(P>O.05).The effectappearing time of qod group was longer than thatof qd and fractional therapy(P<1)05).Therewasn’t difference in the later two gl‘oups(P>0.05).There was notable difference on theside——effects of corticosteroid in three groups(P<0.01).The incidence of side-effects of thefractional therapy group was highest,qd grouplower and qod group lowest. Conclusion It is suggested that adopting qdtherapy of corticosteroid for children with PN S inthe induced remission period iS suitable.