激素不同给药途径联合低分子肝素钠治疗原发性肾病综合征疗效探讨

Clinical Observation Small molecule heparin combined with the different route of administration of Glucocorticoids for on suffering from primary nephritic syndrome

目的探讨激素不同给药途径联合低分子肝素钠治疗原发性肾病综合征（PNS）的疗效。方法观察我院自2000年1月至2007年12月收住院的52例PNS患者。均符合PNS诊断标准，随机分为两组。观察组甲泼尼龙粉针40mg／d，静脉滴注4周，改口服强的松龙片60mg／d。对照组标准剂量为强的松60mg／d口服。两组均用药12周开始减量。每3周减5mg，减量至20mg，隔日顿服。两组均联合低分子肝素钠5000u，间隔12h，2次／d皮下注射。疗程2周。结果两组治疗后2周、4周、8周、12周、16周，观察组总有效率分别为44．32％（12例）、64．77％（18例）、72．72（20例）；对照组总有效率分别为30．20％（8例）、40．48（10例）、64．2％（16例）。结论静脉予以激素治疗治疗PNS可使24h尿蛋白明显下降、白蛋白明显上升。较口服激素治疗病情缓解快，无并发症，获得较好的疗效。

Objective To assess the effect of 2 kinds of treatment of glucocorticoid on primary nephritic syndrome（PNS）. Methods 52 patients with PNS was divided randomly into 2 groups as observation group and constrast group. The observation group was treated with prednisone administrated at intravenous injection 40 mg/d every day for 4 weeks, then to substitute taking orally prednisone 60 mg/d. the control group was treated with prednisone administrated at 60 mg/d. The period of the treatment was 12 weeks, two group begain to reduction at the same time. two groups all was given small molecule heparin, Twice daily subcutaneous injection. Resuits The improvement on the uric protein and plasma albumin significantly different between 2 groups. Conclusion The intravenous injection injection prednisone period take orally preduisone could have nicer effect of controlling PNS. It is availabe to generalize for the treatment of PNS.