雷公藤多苷联合小剂量泼尼松治疗老年原发性肾病综合征临床观察

Clinical observation of tripterygium glycosides combined with small dose of prednisone in the treatment of senile primary nephrotic syndrome

目的 探讨雷公藤多苷联合小剂量泼尼松用于老年原发性肾病综合征治疗的临床效果.方法 对采用雷公藤多苷联合小剂量泼尼松治疗的老年原发性肾病综合征患者40例进行回顾性分析,观察疗效及生化指标变化情况.结果 经治疗6个月后,完全缓解率为57.50%（23/40）,无效率为15.00%（6/40）,总缓解率为85.00%（34/40）;治疗2～24周,患者尿蛋白和血清总胆固醇水平显著下降,血浆清蛋白显著升高,与治疗前比较,差异有统计学意义（P〈0.05）;治疗24周时,患者血清三酰甘油水平显著下降,差异有统计学意义（P〈0.05）;治疗期间不良反应发生率为15.00%（6/40）,并经对症处理后均可耐受治疗.结论 雷公藤多苷联合小剂量泼尼松用于老年原发性肾病综合征的治疗安全、效果显著,值得临床应用.

Objective To investigate the clinical effect of tripterygium glycosides combined with small dose of pred- nisone in treating senile primary nephrotic syndrome. Methods Retrospective analysis was conducted on 40 patients with senile primary nephrotic syndrome ,who received tripterygium glycosides combined with small dose of prednisone for treatment. Thera- peutic effect and change of biochemical indicators were observed. Results After 6-month treatment, the complete remission rate was 57.50% （23/40） and failure rate was 15.00% （6/40） with the total response rate of 85.00% （34/40）. From 2 to 24 weeks of treatment,urine protein and serum total cholesterol levels in patients decreased significantly,while plasma-albumin increased ob viously, and the difference had statistical significance （P〈0.05）. On 24th week of treatment, serum triglyceride level decreased sig nificantly, and the difference had statistical significance （P〈0.05）. During the treatment, the incidence of adverse reaction was 15. 00% （6/40）, and all the patients with adverse reaction could continue tolerated treatment after symptomatic treatment. Conclusion Tripterygium glycosides combined with small dose of prednisone in the treatment of senile primary nephrotic syndrome is safe and effectively significant, which is worthy of clinical application.