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

The Clinical Observation of Tripterygium Glycosides Combined with Low-dose Prednisone in the Treatment of Primary Nephritic Syndrome in Elderly

目的:探讨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的临床应用及疗效。方法:选取2011年2月-2013年5月笔者所在医院收治的老年原发性肾病综合征患者98例,随机将其分为对照组和观察组,各49例,其中对照组患者给予雷公藤多苷进行治疗,观察组给予雷公藤多苷联合小剂量泼尼松进行治疗,治疗前及治疗后第2、4、8、24周分别进行检查,观察24 h尿蛋白定量、血浆白蛋白(Alb)等指标变化情况及疗效。结果:统计结果显示,观察组中完全缓解18例,显著缓解23例,部分缓解5例,无改善3例,总缓解率为83.7%;对照组中完全缓解12例,显著缓解18例,部分缓解14例,无改善5例,总缓解率为61.2%,两组总缓解率比较差异有统计学意义(P<0.05)。蛋白尿、血浆白蛋白等观察指标两组治疗后较治疗前均有所改善,差异有统计学意义(P<0.05)。结论:雷公藤多苷联合小剂量泼尼松在治疗老年原发性肾病综合征中疗效显著,治疗有效率高,预后情况良好,值得在临床上进行推广和应用。

Objective：To investigate the clinical application and efficacy of Tripterygium Glycosides combined with low-dose Prednisone therapy in elderly primary nephritic syndrome.Method：98 patients were selected from February 2011 to May 2013 in our hospital for elderly patients with primary nephritic syndrome,according to the random principle they were divided into control group and the observation group,49 cases in each,the control group was treated with Tripterygium Glycosides treatment,the observation group was treated with Tripterygium Glycosides combined with low-dose Prednisone,the effect and the 24 h urinary protein,plasma albumin（Alb） and so on were observed before treatment and after treatment 2,4,8,24 weeks.Result：The statistical results show, the observation group of 18 cases of complete remission,significant remission in 23 cases,partial remission in 5 cases,no improvement in 3 cases,the total response rate was 83.7%.The control group of 12 cases of complete remission,significantly relieved in 18 cases,partial remission in 14 cases,no improvement in 5 cases,the total response rate was 61.2%.The total response rate in two groups was statistically significant（P〈0.05）.Urine protein,plasma albumin,observed the two groups after treatment than before treatment improved,the differences were statistically significant（P〈0.05）.Conclusion：Tripterygium Glycosides combined with low-dose Prednisone in the treatment of elderly patients with primary nephritic syndrome has a significant effect,the effective rate of the treatment is high, the prognosis is good,it is worthy of promotion and application in clinical practice.