孟鲁司特治疗紫癜性肾炎的临床研究

Clinical Study of Montelukast in the Treatment of Henoch-Schnlein Purpura Nephritis

目的:观察孟鲁司特治疗紫癜性肾炎的临床疗效以指导临床用药。方法:选取紫癜性肾炎患儿62例,各临床类型患儿按不平衡指数最小分配原则分为观察组32例及对照组30例。对照组给予综合治疗,观察组在综合治疗的基础上给予孟鲁司特每次4~5 mg,每天1次口服,共观察治疗4周。结果:观察组与对照组无新发皮疹的时间分别为(3.63±1.06)d、(3.03±0.96)d,皮疹消退的时间分别为(11.36±3.02)d、(9.45±3.11)d,两组比较差异有统计学意义(P<0.05)。观察组治疗4周后血清胱抑素C(1.17±0.49)mg/L,与治疗前的(1.49±0.67)mg/L比较差异有统计学意义(P<0.05);观察组治疗4周后血清β2-微球蛋白(5.07±0.19)mg/L,与治疗前的(9.85±0.36)mg/L及对照组治疗4周后的(8.57±0.82)mg/L比较差异均有统计学意义(P<0.05);观察组治疗4周后尿β2-微球蛋白(0.38±0.19)mg/L,与治疗前的(0.57±0.23)mg/L及对照组治疗4周后的(0.52±0.26)mg/L比较差异有统计学意义(P<0.05);观察组治疗4周后尿微量白蛋白(28.9±19.1)mg/L,与治疗前的(53.6±32.5)mg/L比较差异有统计学意义(P<0.05)。结论:孟鲁司特能缩短过敏性紫癜无新发皮疹及皮疹消失的时间,且能降低血清胱抑素C、尿微量白蛋白、血清及尿β2-微球蛋白含量,故推测孟鲁司特能改善紫癜性肾炎急性期肾损害。

Objective： To investigate the clinical efficacy of montelukast in the treatment of Henoch-Schfinlein purpura nephritis. Methods： Sixty-two children patients were divided into two groups, the treatment group （32 cases） and the control group （30 cases）. Conventional medical treatment was given to both groups. Montelukast was appended in the treatment group, 4 - 5 mg, daily ; the course was four weeks. Results： （ 1 ） In the control group and the treatment group, the time of no new rash were （ 3.63 ± 1.06 ） days and （3.03 ±0.96） days, respectively; rash disappearance time were （11.36±3.02 ） days and （9.45 ±3.11 ） days, there was a statistically significant difference （ P〈0.05 ） respectively. （2） After four weeks＇ treatment, the serum cystatin C, serum β2-microglobulin and urine microalbumin, urine β2-microglobulin were detected. The serum cystatin C in the control group [ （ 1. 17± 0.49 ） mg/L ] was significantly higher than that before treatment [ （1.49±0.67）mg/L] （P〈0.05） ; the serum β2-microglobulin in the treatment group after treatment [ （5.07±0. 19） mg/L] was significantly lower than that in the control group [ （8.57±0.82） mg/L] and before treatment [ （9.85±0.36） mg/L] （ P〈0.05 ）. The urine β2-microglobulin in the treatment group after treatment [ （0.38±0.19） mg/L] was significantly lower than that in the control group [ （0.52±0.26） mg/L ] and before treatment [ （ 0.57 ±0.23 ） mg/L ] （ P〈0.05 ） ; There was significant difference between the the control group after treatment [ （28.9 ± 19.1 ）mg/L ] and before [ （53.6±32.5）mg/L ] of urine microalbumin （ P 〈 0.05 ）. Conclusions： These results suggest that montelukast can shorten the time of no new rash and disappearance time of rash. It also can reduce the serum cystatin C, β2-microglobulin and urine microalbumin. Montelukast can improve acute renal damage of children with Henoch-Scht^nlein purpura nephritis.