肾囊内注射甲泼尼龙治疗儿童难治性紫癜性肾炎

Treating Persistent Henoch-Schonlein Purpura Nephritis by Injecting Methylprednisolone into Intra-Renal Capsule in Children

目的探讨肾囊内注射甲泼尼龙治疗儿童难治性紫癜性肾炎(HSPN)的疗效。方法难治性HSPN患儿22例随机分为3组:Ⅰ组,口服泼尼龙组;Ⅱ组,静脉注射大剂量甲泼尼龙组;Ⅲ组,肾囊内注射甲泼尼松组。连续观察8周,分别于0、4、8周检测患儿24 h尿蛋白量、血清清蛋白(Alb)、肌酐(Scr)、血浆胆固醇(Cho)。结果4周时3组24 h尿蛋白分别为(2.35±1.09)(、0.97±0.37)、(0.99±0.52)g,3组间有显著差异(P<0.01);8周时3组24 h尿蛋白分别为(2.13±1.68)(、1.57±0.89)(、0.19±0.11)g,3组间有显著差异(P<0.05)。观察治疗期间肾囊注药组患儿血清Alb、血浆Cho渐恢复至正常水平。结论肾囊内注射甲泼尼龙可减少难治性HSPN儿童尿蛋白排出。

Objective To evaluate the results of treating the persistent Henoch- Schonlein purpura nephritis （HSPN） by injecting methylprednisolone into intra- renal capsule in children. Methods Twenty- two patients （aged from 6 to 13 years） with persistent HSPN were randomly divided into 3 groups. Group 1 was treated with prednisone; group Ⅱ was treated with high dosage methylprednisolone by venous injection, while group Ⅲ was treated by injecting methylprednisolone into intra- renal capsule. The 24 h urinary protein excretion, the levels of serum albumin and creatinine, or the blood cholesterole in children with persistent HSPN were detected at the beginning, 4 weeks and 8 weeks of the study. The blood pressure, body weight were detected in the study duration. Results The values of 24 h urinary protein excretion were （2.35 ± 1.09）, （0.97 ± 0.37）, and （0.99 ± 0.52 ） g （ P 〈 0.01 ） in patients in 3 groups at 4 weeks. At 8 weeks, the values of 24 h urinary protein excretion were （2.13 ± 1.68）, （ 1.57 ± 0.89） and （0.19 ± 0.11 ） g （ P 〈 0.05 ） in the patients in three groups. The level of serum albumin and the blood cholesterole came back normal at the end of the study in group Ⅲ patients. Conclusion The urinary protein excretion can be decreased in children with persistent HSPN by injecting methylprednisolone into intrarenal.