四种药物肾盂灌注治疗丝虫性乳糜尿的疗效比较

Efficacy of Tetracycline, Erythromycin, Meglumine Diatrizoate, and Silver Nitrate in the Treatment of Patients with Chylous Urine

目的比较非手术治疗乳糜尿的方法。方法随机将115例乳糜尿患者分为红霉素、四环素、泛影葡胺、硝酸银四组,各组患者应用以上四种药物进行肾盂灌注,比较各组患者的乳糜尿消失率,并发症发生情况。结果乳糜尿消失率:红霉素组93.7%,四环素组91.3%,泛影葡胺组64%,硝酸银组88.5%。硝酸银组出现1例休克,1例左肾萎缩,1例左输尿管上段狭窄并发症;泛影葡胺组出现1例过敏性休克;余二组无严重并发症。结论泛影葡胺可出现过敏性休克,疗效较低,红霉素、四环素肾盂灌注治疗乳糜尿简单、安全、有效,并发症少,毒性低,疗效与硝酸银相当,可代替危险性较大的硝酸银灌注法。

Objective The aim of this study was to explore a new non-operative method to treat patients with chylous urine. Methods 115 patients with chylous urine were randomly divided into 4 groups. Patients in each of these groups received renal perfusion with tetracycline, erythromycin, meglumine diatrizoate, or silver nitrate. The response, as judged from the disappearance of ehylous urine and the incidence of complications, was analyzed. Results The response rate in patients treated erythromycin, tetracycline, meglumine diatrizoate and silver nitrate was 93.7%, 91.3%, 64% and 88.5%, respectively. Complications were observed in patients treated with silver nitrate （renal atrophy; 1 case, left ureterostenosis in superior segment; 1 case, and shock; 1 case）. Allergic shock was observed only in 1 patient treated with meglumine diatrizoate. Serious complications were not observed in other groups.Conclusion Therapeutic value of meglumine diatrizoate is relatively lower than tetracycline and erythromycin as it may induce allergic shock. Infusion therapy with tetracycline and erythromycin is a simple, safe and effective therapeutic method to treat chylous urine. This method is comparable to silver nitrate infusion therapy.