经验治疗与肾穿刺活检术辅助治疗肾病综合征的临床研究

Experience in the Treatment of Nephrotic Syndrome with Empiric Therapy and Renal Needle Biopsy

目的研究经验治疗与肾穿刺活检术辅助治疗肾病综合症的临床效果。方法方便收集兴安盟医院2016年1月—2017年2月门诊及住院肾病综合征患者共60例,随机将其分为非肾穿刺组与肾穿刺组,每组均为30例,非肾穿刺组给予经验治疗,肾穿刺组根据病理类型按照KDIGO指南给予治疗,对比两组患者的临床疗效、症状开始缓解时间以及激素减量过程中的复发情况。结果非肾穿刺组的缓解率为70.0%,肾穿刺组为90.0%,肾穿刺组高于非肾穿刺组,对比差异有统计学意义(χ2=3.65,P<0.05)。非肾穿刺组的症状开始缓解时间为(20.1±14.2)d,肾穿刺组为(14.5±10.7)d,肾穿刺组明显短于非肾穿刺组,对比差异有统计学意义(t=4.12,P<0.05)。非肾穿刺组激素减量过程中的复发率为13.3%,肾穿刺组为3.3%,肾穿刺组低于非肾穿刺组,对比差异有统计学意义(t=2.86,P<0.05)。结论肾穿刺活检术辅助治疗肾病综合征的临床效果明显优于经验治疗,可快速缓解临床症状,显著降低激素减量过程中的复发率,值得推行。

Objective To study the clinical effect of empiric therapy and renal biopsy in the treatment of nephrotic syndrome. Methods A total of 60 outpatients and patients with nephrotic syndrome were convenient from January 2016 toFebruary 2017 in the hospital. They were randomly divided into non-renal puncture group and renal puncture group, 30cases in each group. Non-kidney puncture group was given empirical treatment. The renal puncture group was treated according to the KDIGO guidelines according to the pathological type. The clinical efficacy, the onset of symptom relief, andthe recurrence during hormone reduction were compared between the two groups. Results The remission rate was 70.0% inthe non-renal puncture group and 90.0% in the renal puncture group. The renal puncture group was higher than the non-renal puncture group, and the difference was statstically significant （X^2=3.65, P〈0.05）. The time of onset of symptom reliefin the non-renal puncture group was （20.1±14.2）d, and that in the renal puncture group was （14.5±10.7）d. The renal puncture group was significantly shorter than the non-renal puncture group, the difference was statistically signficant（t=4.12, P〈0.05）. The recurrence rate in the non-renal biopsy group was 13.3% in the course of hormone reduction, 3.3% in the renalbiopsy group, and lower in the renal biopsy group than in the non-renal biopsy group （t=2.86, P〈0.05）. Conclusion Theclinical effect of renal biopsy assisted treatment of nephrotic syndrome is significantly better than that of empirical therapy.It can quickly relieve clinical symptoms and significantly reduce the recurrence rate during hormone reduction. It is worthyof implementation.