摘要
目的探讨泼尼松龙联合低分子肝素治疗小儿肾病综合征的疗效及对肾功能指标的影响。方法前瞻性研究选取2015年4月至2017年4月新疆维吾尔自治区人民医院收治的84例小儿肾病综合征患儿,采用随机数字表法将患儿分为对照组与观察组,每组各42例,两组均给予常规的抗感染、利尿消肿、降血压、维持酸碱平衡等方法治疗,对照组在常规治疗的基础上给予泼尼松龙,观察组在对照组基础上加用低分子肝素,对比两组患儿临床疗效、肾功能指标及不良反应发生率。结果对照组临床总有效率为66.19%,观察组临床总有效率为92.86%,观察组与对照组相比,临床总有效率较高,差异具有统计学意义(P<0.05)。对照组治疗后血清肌酐、血尿素氮及血清肌酐清除率水平分别为(117.23±5.89)mmol/L、(5.24±1.23)mmol/L、(60.31±4.90)ml/min,观察组治疗后血清肌酐、血尿素氮及血清肌酐清除率水平分别为(110.23±4.90)mmol/L、(4.82±1.03)mmol/L、(63.09±5.11)ml/min,治疗后,观察组与对照组相比,血清肌酐、血尿素氮水平降低,血清肌酐清除率升高更加显著,差异具有统计学意义(P<0.05)。两组患儿在治疗期间仅有观察组患儿出现了2例皮下瘀斑,占4.76%,两组患儿在治疗期间均未发生肝、肾功能方面的损害,同时也未见内脏、消化道出血等严重不良反应,皮下瘀斑的患儿经对症处理后恢复正常。结论采用泼尼松龙联合低分子肝素治疗小儿肾病综合征疗效显著,能改善患儿的肾功能指标,有效控制患儿病情,并有较高的安全性。
Objective To explore the clinical effect of Prednisolone and low molecular Heparin in the treatment of pediatric nephrotic syndrome and its effect on renal function index. Methods From April 2015 to April 2017,84 cases of children with nephrotic syndrome were randomly divided into control group and observation group,42 cases in each group. The patients of two groups were given routine anti-infection,diuresis detumescence,fall blood pressure,maintain the balance of acid-base method of treatment,on the basis of routine therapy,the control group were treated using Prednisolone,and on the basis of control group,the observation group were combined with low molecular heparin. Clinical curative effect,kidney index and the incidence of adverse reactions were compared. Results The total clinical efficiency of the control group was66. 19 %,and the total clinical efficiency of the observation group was 92. 86%. Compared with the control group,the total effective rate of the observation group was higher than that in the control group,and the difference was statistically significant（ P〈0. 05）. Serum creatinine,blood urea nitrogen and serum creatinine clearance level in control group after treatment were respectively（ 117. 23 ± 5. 89） mmol/L,（ 5. 24 ± 1. 23）mmol/L,（ 60. 31 ± 4. 90） ml/min,serum creatinine,blood urea nitrogen and serum creatinine clearance level in the observation group after treatment were respectively（ 110. 23 ± 4. 90） mmol/L,（ 4. 82 ± 1. 03） mmol/L,（ 63. 09 ± 5. 11） ml/min. After treatment,serum creatinine and blood urea nitrogen in observation group were lower,serum creatinine clearance increased than those of the control group,and the difference was statistically significant（ P〈0. 05）. During treatment,only 2 cases in observation group occurred subcutaneous ecchymosis,accounted for 4. 76%,liver and kidney function damage didn＇t occur,and serious adverse reactions didn＇t occur,such as internal organs and gastrointestinal bleeding,subcutaneous ecchymosis children
作者
拜尔娜·那扎瓦尔
艾力克木·阿不都玩克
巴合提古丽·苏力坦
Baierna·Nazhawaer;Ailikemu·Abuduwanke;Bahetiguli·Sulitan(Department of Pediatrics,People＇s Hospital of XinjiangUygur Autonomous Regio;Department of Pediatrics,People＇s Hospital of Jimunai County,Altay region,Altay xinjiang 836899,China)
出处
《临床和实验医学杂志》
2018年第17期1878-1880,共3页
Journal of Clinical and Experimental Medicine
基金
新疆维吾尔自治区自然科学基金(编号:2016D01C105)
关键词
小儿
肾病综合征
泼尼松龙
低分子肝素
疗效
肾功能指标
Children
Nephrotic syndrome
Prednisolone
Low molecular heparin
Clinical effect
Renal function index
