依那普利联合氢氯噻嗪治疗小儿急性肾小球肾炎临床观察

目的观察依那普利联合氢氯噻嗪治疗小儿急性肾小球肾炎的疗效及尿m ALB、尿NAG的变化,探讨小儿急性肾小球肾炎的治疗方法及其对远期预后的影响。方法将73例小儿急性肾小球肾炎按随机法分为联合治疗组(n=36)和对照组(n=37),对照组患儿仅给予抗感染、改善循环、休息等治疗,联合治疗组患儿在对照组的基础上给予依那普利、氢氯噻嗪口服,2组均在治疗前及治疗后10 d观察临床疗效,测定尿常规、肾功能、尿m ALB、尿NAG。结果联合治疗组总有效率(91.7%)显著高于对照组(81.1%),差异具有统计学意义(P<0.05);治疗后联合治疗组尿常规恢复显著优于对照组(P<0.05),尿m ALB(1.76±0.35)mg/L、尿NAG(0.865±0.236)Umol/L·Cr均显著低于对照组尿m ALB(2.35±0.34)mg/L、尿NAG(1.978±0.521)Umol/L·Cr(P<0.05)。结论小儿急性肾小球肾炎采用依那普利联合氢氯噻嗪治疗能更快改善患儿临床症状及尿常规,显著降低患儿尿m ALB、尿NAG,使患儿远期获益。

Objective To observe the joint hydrochlorothiazide enalaprilat treatment the curative effect of infantile acute glomerulonephritis and urinary mALB, the change of urine NAG, to discuss the treatment of children with acute glomerulonephritis and its impact on long-term prognosis. Methods 73 cases of children with acute glomerulonephritis according to the method of random divided into combined treatment group and control group, the combination therapy group of 36 cases, control group of 37 cases, control group with only gives anti-infection treatment, improve circulation, rest, such as therapy, combined treatment group patients in the control group on the basis of given enalaprilat, hydrochlorothiazide oral, both groups before treatment and after treatment, 10 d to observe the clinical curative effect,the determination of urine routine, renal function, urinary mALB, urine NAG. Results Joint efficiency of treatment group was significantly higher than the control group, the difference is statistically significant（P〈0.05 ）. Combined treatment group after treatment restore is better than that of control group routine urine, urinary mALB（1.76±0.35）, mg/L urine NAG （0.865±0.236）Umol/LoCr were significantly lower than the control groupurinary mALB（2.35±0.34）mg/L, urine NAG （ 1.978±0.521 ） Umol/L-Cr. （P〈0.05）. Conclusion Children with acute glomerulonephritis with enalaprilat combined therapy with hydrochlorothiazide children improve clinical symptoms and routine urine more quickly, and can significantly reduce the children with urinary mALB, urine NAG, make children with long-term benefit.