环磷酰胺冲击联合激素治疗难治性肾病综合征的临床效果评价

Clinical effect evaluation of cyclophosphamide pulse therapy combined with hormone in the treatment of refractory nephrotic syndrome

目的分析环磷酰胺冲击联合激素治疗难治性肾病综合征的临床效果。方法回顾性分析我院收治的68例难治性肾病综合征患者的临床资料,将按照治疗方法分为观察组与对照组,每组32例。其中对照组采用常规激素治疗,观察组则在对照组的基础上联合环磷酰胺冲击进行治疗。比较两组患者的临床缓解效果、生化指标及不良反应。结果观察组患者总缓解率为94.12%,显著高于对照组的55.88%,差异具有统计学意义(P<0.05)。治疗前,两组患者尿蛋白、血浆白蛋白、血肌酐水平比较,差异不显著(P>0.05);治疗后,两组患者尿蛋白、血浆白蛋白、血肌酐水平均改善,且观察组优于对照组(P<0.05)。观察组总不良反应发生率为5.88%,略低于对照组的20.59%(P>0.05)。结论针对难治性肾病综合征患者采用环磷酰胺冲击联合激素治疗临床效果显著,不良反应少,具有较高的临床应用价值。

Objective To understand the clinical effect of cyclophosphamide pulse therapy combined with hormone in the treatment of refractory nephrotic syndrome. Methods The clinical data of 68 patients with refractory nephrotic syndrome in our hospital was retrospectively analyzed, patients were divided into observation group and control group according to different treatment methods, with 32 cases in each group. The control group received conventional hormone therapy, while the observation group accepted cyclophosphamide pulse therapy on the basis of the control group. The clinical remission effect, biochemical indexes and adverse reactions of patients in the two groups were compared. Results The total remission rate of the patients in the observation group was 94.12%, which was higher than 55.88% of the control group（P〈0.05）. Before treatment, the levels of urinary protein, plasma albumin, serum creatinine in the two groups were not significantly different（P〉0.05）; after treatment, the levels of urinary protein, plasma albumin, serum creatinine in the two groups improved,and those of the observation group were better than the control group, the differences were statistically significant（P〈0.05）.The total incidence of adverse reactions in the observation group was 5.88%, which was slightly lower than 20.59% of the control group, but the difference was not statistically significant（P〉0.05）. Conclusion The cyclophosphamide pulse therapy combined with hormone in the treatment of patients with refractory nephrotic syndrome has remarkable effect, with low incidence of adverse reactions, which has good clinical application value.