孟鲁司特钠联合双嘧达莫对儿童过敏性紫癜肾损害的保护作用被引量：15

The protective effect of montelukast sodiumon combined with dipyridamole on renα1 damage in children with Henoch-Schonlein purpura

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摘要目的探讨孟鲁司特钠联合双嘧达莫对过敏性紫癜（henoch-schonlein purpura，HSP）患儿肾损害的。肾保护作用。方法将146例尿常规检查正常的HSP患儿分为3组，对照组（A组）46例给予维生素C、芦丁等常规治疗；B组57例在A组常规治疗基础上加用孟鲁司特钠治疗；C组43例在常规治疗的基础上加用孟鲁司特钠和双嘧达莫治疗。3组分别于入院时，治疗后第1个月检测尿免疫球蛋白G（immunoglobulin，IgG）、微量白蛋白（micro-albumin，mAlb）、转铁蛋白（transferrin，TRF）、Ct1微球蛋白（a1-microglobulin，a1-MG）、p2微球蛋白（p2-microglobulin，β2-MG）和N-乙酰-β-氨基葡萄糖苷酶（N-acetyl-β-D-glucosaminidase，NAG）的含量。随访6个月；比较3组血尿和（或）蛋白尿的发生率、发病时间及临床分型。结果A组治疗前后TRF、mAlb、82-MG、NAG含量比较，差异有统计学意义（P〈0．01，P〈0．05）；B、C组治疗后第1个月IgG、mAlb、TRF、α1-MG、B2-MG和NAG均较治疗前降低，除α1-MG外，差异有统计学意义（P％0．01）；B、C组治疗后第1个月IgG、mAlb、TRF、α1-MG、B2-MG和NAG均较A组降低，除Ⅸ1-MG外，差异有统计学意义（P〈0．01）；治疗后第1个月各组间IgG、mAb、TRF、α1-MG、82-MG和NAG比较，除a1-MG外，差异有统计学意义（P〈0．01）；B、C组血尿和（或）蛋白尿的发病率、发病时间及临床分型与A组比较，差异有统计学意义（P〈0．05，P〈0．01）。结论应用孟鲁司特钠或孟鲁司特钠联合双嘧达莫治疗HSP，对HSP早期肾损害均有保护作用，可能对HSP肾损害有预防作用。孟鲁司特钠联合双嘧达莫对过敏性紫癜肾损害进行早期干预疗效优于单用孟鲁司特钠。 Objective To investigate the protective effect of montelukast sodium or montelukast sodiumon combined with dipyridamole on early renα1 damage in children with Henoch-Schonlein purpura （HSP）. Methods 146 cases of HSP with normα1 routine urine examination results were divided into three groups at random： the control group （group A,46 cases） given common therapy;group B （57 cases） treated with montelukast sodium plus common therapy;group C （43 cases） treated with montelukast sodium combined with dipyridamole plus common therapy. Three groups received test of urinary protein family （immunoglobulin G）（IgG）, transferrin （TRF）, micro-α1bumin （mAlb）, α1-microbailoons protein （α1-MG）,and 2-microbaiioons protein （2-MG） and urinary enzymes （NAG） on admission and one month after treatment. Follow up for a year, after treatment to compare hematuria and/or proteinuria incidence, infection time and clinicα1 classification. Results There was significant difference in TRF,mAlb,α2-MG and NAG in group A before and after treatment （P〈0. 01, or P〈0. 05）. The contents of IgG, mAlb, TRF, α1-MG, β2-MG and NAG were significantly reduced after one-month treatment in groups B and C, except α1-MG （P〈0. 01 ）. The contents of IgG, mAlb, TRF, α1-MG, β2-MG and NAG were significantly reduced after one-month treatment in group C as compared with groups B and A, except α1-MG （P〈0. 01）. There was significant difference in the incidence and onset time of hematuriae and/or proteinuria and clinicα1 classification between groups B and C with group A （P〈0. 05, or P〈0. 01）. Conclusions Montelukast combined with dipyridamole or Montelukast sodium α1one plays a protective role for patient with early renα1 damage caused by HSP, and may prevent the HSP-induced renα1 damage. The efficacy of montelukast combined with dipyridamole in treating the HSP-induced renal damage is more satisfactory than montelukast used α1one.