泼尼松联合吗替麦考酚酯治疗儿童紫癜性肾炎的疗效探讨

Therapeutic Effect of Prednisone Combined with Mycophenolate Mofetil on Children with Purpuric Nephritis

目的探讨泼尼松联合吗替麦考酚酯治疗儿童紫癜性肾炎的疗效。方法方便选择2010年1月—2017年12月该院收治的紫癜性肾炎患儿104例,以随机数表法将其分为对照组与研究组,每组52例。对照组应用环磷酞胺与泼尼松治疗,研究组应用吗替麦考酚酯与泼尼松治疗。观察对比两组临床疗效、尿蛋白与血尿的消失时间,以及药物不良反应。结果研究组治疗的总有效率为96.15%,高于对照组82.69%,差异具有统计学意义(χ~2=4.981,P<0.05)。研究组尿蛋白消失时间(19.2±5.3)d、血尿消失时间(35.2±8.5)d,均低于对照组(26.5±4.5)d、(47.5±8.8)d,差异有统计学意义(t=5.523,6.230,P<0.05)。研究组胃肠道不良反应的发生率3.85%低于对照组19.23%,差异有统计学意义(χ~2=6.029,P<0.05)。研究组致病菌感染的发生率1.92%与对照组3.85%对比差异无统计学意义(χ~2=0.000,P>0.05)。结论泼尼松联合吗替麦考酚酯治疗儿童紫癜性肾炎疗效可靠,能够缩短恢复速度,安全性较佳,适于临床推广。

Objective To investigate the efficacy of prednisone combined with mycophenolate mofetil in the treatment of children with purpuric nephritis.Methods 104 children with purpuric nephritis admitted to our hospital from January 2010 to December 2017 were convenient randomly divided into control group and study group,with 52 cases in each group.The control group was treated with cyclophosphamide and prednisone,and the study group was treated with mycophenolate mofetil and prednisone.The clinical efficacy,disappearance time of urinary protein and hematuria,and adverse drug reactions were observed and compared.Results The total effective rate of the study group was 96.15%,which was higher than that of the control group(82.69%).The difference was statistically significant(χ^2=4.981,P<0.05).The urinary protein disappearance time(19.2±5.3)d and the hematuria disappearance time(35.2±8.5)d were lower in the study group than in the control group(26.5±4.5)d and(47.5±8.8)d,the different was statistically significant(t=5.523,6.230,P<0.05).The incidence of gastrointestinal adverse reactions in the study group was 3.85%lower than that in the control group 19.23%(χ^2=6.029,P<0.05).There was no significant difference in the incidence of pathogenic infection between the study group 1.92%and the control group 3.82%,the different was statistically significant(χ^2=0.000,P>0.05).Conclusion Prednisone combined with mycophenolate mofetil in the treatment of children with purpuric nephritis is reliable,can shorten the recovery rate,and has better safety and is suitable for clinical promotion.