甲基强的松龙联合环磷酰胺冲击治疗难治性肾病对心功能的影响与护理

Effect of combination therapy of methylprednisolone and cyclophosphamide on heart function and nursing in patients with refractory nephritic syndrome

目的探讨甲基强的松龙（MP）联合环磷酰胺（CTX）冲击治疗难治性肾病对患儿心功能的影响。方法对收治的30例难治性肾病患儿，在进行MP联合CTX冲击治疗时，监测患儿的心功能，记录治疗前、治疗中患儿的心率、血压变化，并观察并发症情况。结果治疗中患儿的心率加快，血压升高，与治疗前比较有统计学意义（P〈0．05）。MP治疗时心悸、头晕等并发症易发生在第3次治疗中；CTX治疗时恶心、呕吐、心悸等并发症易发生在首次疗程中，骨髓抑制、肝功损害易发生在后续疗程中。结论在MP联合CTX冲击治疗难治性肾病时，应监测患儿的心功能变化，根据心率、血压变化及时采取相应的措施，减少并发症的发生。

Objective To evaluate the heart function of patients with refractory nephrotic syndrome during a combination therapy of methylprednisolone （MP） and cyclophosphamide （CTX）. Methods From January 2004 to December 2007, 30 patients with refractory nephrotic syndrome, who were in hospital and received a combination therapy of MP and CTX, were recorded for their heart rate and blood pressure before and during treatment, as well as observed for the complications. Results Comparing with those before treatment, patients＇ heart rates were much quickly and their blood pressure were remarkably higher during the combination treatment, and there was a statistic significance （P 〈 0. 05）. When patients received MP treatment, complications, such as cardiopalmus and dizziness, proned to emerging in the third cycle. When they received CTX treatment, complications, just like sicchasia, vomit and cardiopalmus, appeared in the first cycle. In addition, myelosuppression and lesion of liver function often occurred during the sequence therapy. Conclusions When patients received a combination therapy of MP and CTX, we should monitor their heart funcion so as to promptly make propotional measure and prevent complications according to variation of heart rate and blood pressure.