反复输入白蛋白对儿童单纯性肾病缓解与复发的影响

Impactsofrepeatedlyintravenousalbumininfusiononremisonandrelapseofidiopathicnephroticsyndromeinchildren

对４１例单纯性肾病综合征（简称肾病）患儿，给予泼尼松中长程疗法治疗。其中２０例（Ａ组）同时反复接受静脉输入白蛋白治疗，剂量为４．９±２．１克／次；余２１例（Ｂ组）为对照组。结果表明，Ａ组患儿于治疗期间出现ＢＵＮ增高，平均水肿消退时间、肾病达缓解时间均较Ｂ组显著延迟，分别延迟至２１．４±２．６（ｘ±ｓｘ）天（Ｂ组为６．９±０．５天）、３４．８±３．７（ｘ±ｓｘ）天（Ｂ组为１１．４±１．５天）；复发率显著高于Ｂ组。提示反复输入白蛋白不利于单纯性肾病缓解，并可增加复发。

Forty-onechildrenwithidiopathicnephroticsyndrome(INS)treatedwithmiddletolong-termsteroidsweredividedintotwogroups.TwentycasesingroupAreceivedalbuminbyintra-venousinfusion(4.9±2.1geachtime,for3～12times).Twenty-onecasesingroupBwereascon-trols.Thedatashowedthat(1)ingroupA,thevalueofserumBUNwereincreasedsignificantlywiththeuseofalbumin;(2)ittook24.4±2.6(x±sx)daystoremoveedemaingroupA,VS.6.9±0.5(x±sx)daysincontrols(P<0.01);(3)ittook34.8±3.7(x±sx)daystoeliminateprotein-uriaingroupA,VS.11.4±1.5(x±sx)daysincontrols(P<0.01);(4)therecurenecerate(88.9%)ofINSingroupAwassignificantlyhigherthanthat(38.1%)ingroupB.Itisindicatedthatrepeatedlyintravenousalbumininfusionmaybeoneofthecausativefactors,withwhichINSrelapseandbecomerefractory.