前列腺素E_1治疗原发性肾病综合征的临床观察

Clinical effect of prostaglandin E_1 on primary nephrotic syndrome

目的探讨前列腺素E1(PGE1)脂微球载体剂治疗原发性肾病综合征的临床效果。方法将38例临床诊断原发性肾病综合征随机分成治疗组20例和对照组18例,两组的基本治疗是强的松及降血脂药物治疗。治疗组在基本治疗的基础上应用PGE1脂微球载体剂,对照组加用低分子肝素钙,疗程均为4周。观察两组血纤维蛋白原(FIB)、24h尿蛋白、血清白蛋白(ALB)的水平治疗前后变化。结果两组治疗前后自身对比,FIB、24h尿蛋白下降和ALB上升差异有显著性(P<0.05);治疗组的尿蛋白下降和ALB的上升与对照组相比差异有显著性(P<0.05),但FIB下降差异无明显性(P>0.05)。结论在糖皮质激素的基础上加用PGE1脂微球载体剂或加用低分子肝素钙治疗原发性肾病综合征,都可使患者的高凝状态明显缓解,防止血栓形成,但是前者使患者的尿蛋白减少和血清白蛋白上升方面疗效优于后者。

Objective To investigate the effects of prostaglandin E_1(PGE_1) in patients with primary nephritic syndrome(PNS).Methods 38 patients with PNS were divided randomly into treated group(n=20) which were given with PGE_1 and control group(n=18) which were given with low molecular weight heparin(LMWH) in 4 weeks.Tow groups were treated with the same base of steroid and Fenofibrate .Results A significant decrease of plasm FIB,24 h urinary and a significant increase of serum albumin were observed in two groups(P<0.05). A significant decrease of in 24 h urinary and increase of serum albumin was observed in the treated group compared with those in the control group after 4 weeks'treatment(P<0.05).Mais plasm FIB without a significant difference between two groups after treatment.Conclusion The treatment with PGE_1 or LMWH for PNS can significantly decrease plasm FIB and protect against high thrombotic risk of PNS. PGE1 for PNS can significantly decrease the proteinuria and increase serum albumin compared with LMWH.[