儿童急性链球菌感染后肾炎致肾病综合征激素的治疗作用  

Therapeutic effects of glucocorticoids on the children nephrotic syndrome caused by acute nephritis after streptococcal infection

作　　者：洪建东[1] 施丽景[1] 郑天文[1] 苏志强[1] 付清流[1] 

机构地区：[1]福建省泉州市儿童医院,362000

出　　处：《中国小儿急救医学》2009年第6期550-552,共3页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨糖皮质激素对儿童急性链球菌感染后肾炎（PSAGN）致肾病综合征（NS）的治疗作用。方法采取开放对照研究的方法对63例呈NS表现的儿童PSAGN在常规治疗的基础上给予标准中长程的泼尼松治疗。治疗结果与常规治疗组进行对比。结果激素组治疗6个月末95．2％（60／63）尿蛋白阴转，12个月末100％（63／63）阴转；常规组在相同时期尿蛋白阴转率分别为74％（37／50）和80％（40／50）。激素组治疗12个月末95．2％（60／63）镜下血尿消失，18个月末100％（63／63）消失；常规组在相同时期镜下血尿消失率分别为72％（36／50）和84％（42／50）。激素组治疗2个月末血压恢复正常为92．1％（35／38），3个月末为100％（38／38）；常规组在相同时期血压恢复正常分别为72．7％（24／33）和84．8％（28／33）。激素组治疗1个月末肾功能恢复正常为91．7％（11／12），2个月末为100％（12／12）；常规组在相同时期分别为42．9％（3／7）和57．1％（4／7）。两组的上述治疗效果差异有显著性（P〈0．05或P〈0．01）。结论对PSAGN致NS患儿使用糖皮质激素治疗可有效减少尿蛋白及镜下血尿，促使肾功能、血压较快恢复，改善预后，减少肾脏慢性病变。Objective To investigate the effects of glucocorticoids （GC） on the nephrotic syndrome （NS） caused by acute nephritis after streptococcal infection （PSAGN） in children. Methods Sixty-three children with the NS caused by PSAGN were studied controlly, all of them were administrated with standard long-term prednisone treatment based on the conventional treatment. The treatment outcome was compared with that of the conventional treatment group. Results 95.2% （60/63） of patients in the GC group, the urinary protein became negative at the end of six months, 100% （63/63） negative at the end of twelve months. And in the conventional group the negative rates were 74% （37/50） and 80% （40/50） respectively at the same time. 95.2% （ 60/63 ） of patients in the GC group microscopic hematuria disappeared at the end of twelve months, 100% （63/63） disappeared at the end of eighteen months. And in the conventional group the disappearance rates were 72% （36/50） and 84% （42/50） respectively at the same time. 92. 1% （35/38） of patients in the GC group blood pressure returned to normal at the end of two months,100% （38/38） normal at the end of three months. And in the conventional group the normal rates were 72. 7% （24/33） and 84. 8% （28/33） respectively at the same time. 91.7% （11/12） of patients in the GC group showed normal renal function at the end of one month, 100% （12/12） normal at the end of two months. And in the conventional group the normal rates were 42. 9% （3/7） and 57. 1% （12/12） at the same time. There were significant differences in the outcomes between the two groups （ P 〈 0. 05 or P 〈 0. 01 ）. Conclusion With the use of GC for the NS caused by PSAGN in children,it can effectively reduce the duration of urinary protein and microscopic hematuria,and promote rapid reco,：ery of renal function and blood pressure, thereby improving the prognosis.

关 键 词：肾病综合征 急性链球菌感染 肾小球肾炎 糖皮质激素 儿童 

分 类 号：R726[医药卫生—儿科]