维生素A有预防急性肾盂肾炎后瘢痕形成的作用

Vitamin A decreases renal scarring after acute pyelonephritis

目的评估维生素A在预防儿童急性肾盂肾炎后肾瘢痕形成中的作用。方法挑选经临床及二巯基丁酸(DMSA)肾显像扫描确诊的急性肾盂肾炎的儿童进行临床试验研究,86例患者被随机分为两组,实验组接受头孢曲松和维生素A治疗,对照组只接受头孢曲松治疗,疗程6个月。治疗前与6个月后,进行DMSA肾显像扫描,并比较两组之间的肾瘢痕形成及肾损伤的程度。结果共有86例患者(男女比例为17:69)进入本研究,平均年龄为3.7±1.2岁,实验组维生素A的平均水平为67±21μg/dL,对照组为63±28μg/dL。实验前,两组间DMSA扫描肾损伤的程度无明显差异(P】0.05),6个月后DMSA扫描结果显示,与对照组相比,实验组肾功能损伤及瘢痕形成的程度明显改善(P【0.01)。结论维生素A可减少肾盂肾炎肾损伤及瘢痕形成的程度,可用于儿童急性肾盂肾炎的辅助治疗。

Objective In order to evaluate the role of vitamin A in preventing renal scaring after acute pyelonephritis in children.Methods Selected the patients of acute pyelonephritis in children by clinical and dimercaptosuccinic acid(DMSA) renal scintigraphy scan in the clinical trials,86 patients were randomly divided into two groups,study group received ceftriaxone and vitamin A and control group only received ceftriaxone for 6 months.DMSA renal scintigraphy was performed before the start of the treatment and 6 months later,and compared the degree of renal damage and renal scarring between the two groups.Results A total of 86 patients(male:female 17:69) enrolled in the study,and the average age of 3.7 ± 1.2 years.The average level of vitamin A was 67 ± 21 μg /dL in the study group,the control group was 63 ± 28 μg /dL.Before the experiment,DMSA renal scintigraphy was not significant difference between the two groups(P > 0.05),the results of DMSA scan after 6 months show that,compared with the control group,the degree of renal scarring and renal function were significant change in the study group(P <0.01).Conclusion Vitamin A was useful in decreasing the amount of the injury and scarring following the pyelonephritis,and can be used in conjunction with other treatments in the management of acute pyelonephritis in children.