儿童原发性肾病综合征不同种类糖皮质激素治疗的临床研究  

Clinical observation on treatment of childhood primary nephritic syndrome with glucocorticoids

作　　者：成学琴[1] 鲍华英[1] 张爱华[1] 吴红梅[1] 张维真[1] 陈颖[1] 韩媛[1] 

机构地区：[1]南京医科大学附属南京儿童医院,江苏南京210008

出　　处：《临床儿科杂志》2013年第2期159-161,共3页Journal of Clinical Pediatrics

摘　　要：目的观察两种不同剂型的糖皮质激素治疗原发性肾病综合征的效应及不良反应。方法将40例初治的原发性肾病综合征患儿随机分为两组,分别以甲基泼尼松龙(甲泼尼龙)和泼尼松作为诱导缓解治疗的药物,观察比较两组患儿的治疗效果及不良反应。结果两组患儿对激素反应(激素敏感、激素依赖、激素耐药)的差异无统计学意义。对于激素敏感患儿,甲泼尼龙组尿蛋白阴转时间(9.5±1.1)d少于泼尼松组的(14.7±1.4)d,差异有统计学意义(P<0.05);两组患儿在发生高血压、感染次数、血糖异常及肾上腺皮质功能不全方面的差异无统计学意义(P均>0.05);口服甲泼尼龙组更易出现多毛(面部,背部为主),兴奋度明显增高,且柯兴综合征较严重,两组比较差异有统计学意义(P均<0.05)。结论甲泼尼龙诱导肾病综合征缓解优于泼尼松,可缩短激素治疗疗程,但同时有较多的糖皮质激素不良反应。Objectives To observe the efficacy and side effects of two glucocorticoids in treatment of primary nephrotic syndrome. Methods Forty children with primary nephrotic syndrome were randomly divided into 2 groups and were conducted with methylprednisolone and prednisone, respectively. Treatment effects and side effects were observed Results No statistical significances were found between two groups in responses to glucocorticoids, including sensitivity, steroid-dependence and steroid-resistance. For sensitive children, time for urinary protein negative conversion was shorter in methylprednisolone group （9.5~1.1 days） than that in the prednisone group （14.7~1.4 days） with statistical significance （P〈0.05）. No significant differences were found in hypertension, infection frequency, abnormal blood sugar and adrenal insufficiency between the two groups. Hypertrichosis was observed （mainly on face and back） and excitement degree increased in methylprednisolone group. Cushing syndrome was severer in methylprednisolone group than that in prednisone group with statistical significance. Conclusions Methylprednisolone is superior to prednisone to induce remission in nephrotic syndrome. Though it causes more side effects it can shorten course of treatment.

关 键 词：肾病综合征 甲基泼尼松龙 泼尼松 儿童 

分 类 号：R726.9[医药卫生—儿科]