扁桃体切除对伴有慢性扁桃体炎的慢性肾炎患者的长期疗效和安全性观察

The Long-term Efficacy and Safety Observation of Tonsillectomy for Chronic Nephritis with Chronic Tonsillitis Patients

目的:了解扁桃体切除对伴有慢性扁桃体炎的慢性肾炎的长期疗效和安全性。方法:选择合并慢性扁桃体炎的尿常规蛋白≤2+的且肾功能正常的慢性肾炎患者121例,排除了继发性肾病,在医师建议和患者自愿的原则下将患者分为两组,扁桃体切除组52例,非扁桃体切除组69例,随访3年,观察收集上述患者的尿常规+沉渣镜检、24 h尿蛋白定量、呼吸道感染等情况。结果:扁桃体切除组资料较完整者41例,非扁桃体切除组资料较完整者56例。随访3年时两组24 h蛋白尿和血尿均下降,扁桃体切除组下降尤其明显,差异均有统计学意义(P<0.05)。扁桃体切除组扁桃体切除后1个月,25例尿常规完全缓解,11例部分缓解,5例无效。随访3年,32例完全缓解,6例部分缓解,3例无效。非扁桃体切除组,随访3年,23例完全缓解,19例部分缓解,14例无效。随访3年,扁桃体切除组有效率高于非扁桃体切除组,差异有统计学意义(P<0.05)。两组咽部不适、干咳、肝功能、肾功能异常发生情况比较差异无统计学意义(P>0.05)。结论:扁桃体切除对于病情相对较轻的伴有慢性扁桃体炎的慢性肾炎患者有较好远期疗效和安全性。

Objective： To investigate the long-term efficacy and safety of tonsillectomy for chronic nephritis with chronic tonsillitis.Method： 121 patients with chronic nephritis of urine protein ≤2＋ and normal renal function with chronic tonsillitis were selected, secondary nephropathy was excluded, and under the principle of voluntary these patients were divided into two groups, 52 cases in tonsillectomy group, 69 cases in non tonsillectomy group.They were followed for 3 years ancl the data of routine urine sediment microscopy, 24 hours urine protein, respiratory tract infection etc were observed.Result： There were 41 patients with whole data in the tonsillectomy group, 56 patients with whole data in the non tonsillectomy group.During three years of follow-up, 24 h proteinuria and hematuria of patients in the two groups decreased, fairly obvious in the tonsillectomy group, the differences were statistically significant（P〈0.05）.1 months after resection, for patients in the tonsillectomy group, there were 25 patients with complete remission, 11 patients with partial remission, and 5 patients with ineffective.There were 32 patients with complete remission, 6 patients with partial remission, and 3 patients with ineffective after three years of follow-up.At the time there were 23 patients with complete remission, 19 patients with partial remission, and 14 patients with ineffectivenan in the non tonsillectomy group.After three years follow-up, the effective rate of the tonsillectomy group was higher than that of the non tonsillectomy group, the difference was statistically significant（P〈0.05）.There were no statistically significant differences in incidence of upper respiratory tract infection, dry cough, liver function and renal function between the two granps（P〉0.05）. Conclusion： Tonsillectomy for the relative light condition of chronic tonsillitis with chronic nephritis has good long-term efficacy and safety.