地塞米松与甲基强的松龙冲击治疗肾病综合征的比较研究

A Comparative Study between Dexamethasone and Methylprednisolon Impact Therapy in Patients with Nephrotic Syndrome

目的 :比较大剂量地塞米松 (Dexamethasone ,Dex)与甲基强的松龙 (Methylprednisolone,MP)冲击治疗成人原发性肾病综合征 (Nephroticsyndrome ,NS)的疗效、不良反应 ,为价廉的Dex代替昂贵的MP提供临床可行性依据。方法 :Dex组 30例用Dex 2 .0mg/ (kg·d) ,3d为 1疗程 ,3周重复 ,共 2～ 4疗程 ,间歇期以强的松 (Prednisone ,Pred) 0 .6mg/ (kg·d)口服 ,缓解者 8周或用药 12周无效者逐渐减量 ,至 15mg/d维持 ,总疗程 18月 ;MP组 12例用MP 1.0g/d ,3d为 1疗程 ,余同Dex组。结果 :两组的疗效和副作用无统计学差异 (P >0 .0 5 )。结论 :Dex可以替代MP对NS患者进行冲击治疗 ,获得满意疗效及较好的耐受性 ,并为病人节省开支。

Objective To investigate therapeutic efficacy,side effect,and cost of dexamethasone (Dex) and Methylprednisolone (MP) impact therapy in adult patients with nephrotic syndrome (NS).Methods Dex group consisted of 30 cases used Dex 2.0 mg/(kg·d),3 days as a course of treatment,3 weeks for the interval time and used prednisone(Pred) 0.6 mg/(kg·d) at interval. Every case was conducted 2 to 4 courses of treatment.Patients who were remittent in 8 weeks or ineffective in 12 weeks reduced the doses of Pred to 15 mg/d.The total time of treatment was 18 months. MP group consisted of 12 cases used MP 1.0 g/d and the rest means were the same as Dex group's.Results There were no significant difference in therapeutic efficacy and side effects between the two groups, but Dex group cost less than MP group.Conclusion Dex impact therapy is a better inexpensive way for the treatment of patients with NS than MP impact therapy.