目的探讨槐杞黄颗粒联合环孢素A(CsA)治疗儿童原发性肾病综合征(PNS)的临床疗效。方法选取医院2017年1月至2018年2月收治的PNS患儿85例,按随机数字表法分为观察组(43例)与对照组(42例)。两组均给予醋酸泼尼松片治疗,治疗4周后对照组加用...目的探讨槐杞黄颗粒联合环孢素A(CsA)治疗儿童原发性肾病综合征(PNS)的临床疗效。方法选取医院2017年1月至2018年2月收治的PNS患儿85例,按随机数字表法分为观察组(43例)与对照组(42例)。两组均给予醋酸泼尼松片治疗,治疗4周后对照组加用CsA治疗,观察组在对照组基础上加用槐杞黄颗粒治疗,均治疗3个月。结果观察组总有效率为93.02%,明显高于对照组的76.19%(P<0.05);治疗后,两组患者的24 h尿蛋白定量(24 h UP)、血肌酐(SCr)及尿素氮(BUN)水平均明显低于治疗前,血清白蛋白(ALB)水平明显高于治疗前,差异均有统计学意义(P<0.05),但组间比较无差异(P>0.05);观察组患者的免疫球蛋白G(IgG)、CD3^+、CD4^+水平及CD4^+/CD8^+均明显高于对照组(P<0.05);观察组不良反应发生率与对照组相当(30.23%比19.05%,P>0.05)。结论槐杞黄颗粒联合CsA治疗PNS疗效较好,安全性较高,还可明显改善患儿的免疫功能。展开更多
Background:The role of idiopathic nephrotic syndrome(INS)in the pathogenesis of atherosclerosis in childhood has not been clearly elucidated.However,antioxidative defense in INS is thought to be imbalanced.This study ...Background:The role of idiopathic nephrotic syndrome(INS)in the pathogenesis of atherosclerosis in childhood has not been clearly elucidated.However,antioxidative defense in INS is thought to be imbalanced.This study aimed to assess the changes of plasma concentration of selected aminothiols in the blood of children with INS at various stages of the disease.Methods:This cross-sectional study was conducted in 125 children aged 2-18 years.The children were divided into 4 groups:group A,early relapse(n=37);group B,early remission for 4-6 weeks from the onset(n=37);group C,late steroid-free remission(n=31);and group D,long-term remission for 2-5 years(n=20).Control group(E)consisted of 30 age-and gender-matched healthy children.The study protocol comprised an analysis of plasma concentrations of glutathione,homocysteine,cysteine and cysteinylglycine by high-performance liquid chromatography.Fractions of protein-bound and free aminothiols were measured.Endothelial injury was assessed by thrombomodulin,PAI-1 concentration,and von Willebrand factor activity.Results:The children with INS had unbalanced aminothiol metabolism only in relapse and early remission,that shifted towards increased oxidative processes.Administration of cyclosporine A caused a significant increase in homocysteine and cysteine concentration.Changes in aminothiol metabolism were significantly related to endothelial injury.Conclusion:The fi ndings of this study may be helpful in elucidating the pathogenesis of premature atherosclerosis in patients with INS refractory to the treatment or in the case of frequent relapse.展开更多
文摘目的探讨槐杞黄颗粒联合环孢素A(CsA)治疗儿童原发性肾病综合征(PNS)的临床疗效。方法选取医院2017年1月至2018年2月收治的PNS患儿85例,按随机数字表法分为观察组(43例)与对照组(42例)。两组均给予醋酸泼尼松片治疗,治疗4周后对照组加用CsA治疗,观察组在对照组基础上加用槐杞黄颗粒治疗,均治疗3个月。结果观察组总有效率为93.02%,明显高于对照组的76.19%(P<0.05);治疗后,两组患者的24 h尿蛋白定量(24 h UP)、血肌酐(SCr)及尿素氮(BUN)水平均明显低于治疗前,血清白蛋白(ALB)水平明显高于治疗前,差异均有统计学意义(P<0.05),但组间比较无差异(P>0.05);观察组患者的免疫球蛋白G(IgG)、CD3^+、CD4^+水平及CD4^+/CD8^+均明显高于对照组(P<0.05);观察组不良反应发生率与对照组相当(30.23%比19.05%,P>0.05)。结论槐杞黄颗粒联合CsA治疗PNS疗效较好,安全性较高,还可明显改善患儿的免疫功能。
基金The study was supported by KBN 2 P05E 03426 grant of Polish Ministry of Science.
文摘Background:The role of idiopathic nephrotic syndrome(INS)in the pathogenesis of atherosclerosis in childhood has not been clearly elucidated.However,antioxidative defense in INS is thought to be imbalanced.This study aimed to assess the changes of plasma concentration of selected aminothiols in the blood of children with INS at various stages of the disease.Methods:This cross-sectional study was conducted in 125 children aged 2-18 years.The children were divided into 4 groups:group A,early relapse(n=37);group B,early remission for 4-6 weeks from the onset(n=37);group C,late steroid-free remission(n=31);and group D,long-term remission for 2-5 years(n=20).Control group(E)consisted of 30 age-and gender-matched healthy children.The study protocol comprised an analysis of plasma concentrations of glutathione,homocysteine,cysteine and cysteinylglycine by high-performance liquid chromatography.Fractions of protein-bound and free aminothiols were measured.Endothelial injury was assessed by thrombomodulin,PAI-1 concentration,and von Willebrand factor activity.Results:The children with INS had unbalanced aminothiol metabolism only in relapse and early remission,that shifted towards increased oxidative processes.Administration of cyclosporine A caused a significant increase in homocysteine and cysteine concentration.Changes in aminothiol metabolism were significantly related to endothelial injury.Conclusion:The fi ndings of this study may be helpful in elucidating the pathogenesis of premature atherosclerosis in patients with INS refractory to the treatment or in the case of frequent relapse.
