不同种类糖皮质激素治疗儿童原发性肾病综合征的疗效及不良反应研究  

Therapeutic effect and adverse reactions of different kinds of glucocorticoids in children with primary nephrotic syndrome

作　　者：易玲[1] 陈青[2] 曾海江[1] 钟涛[1] 黄郁波[1] 董显燕[1] YI Ling;CHEN Qing;ZENG Haijiang;ZHONG Tao;HUANG Yubo;DONG Xianyan(Department of Pediatric,Ganzhou People's Hospital in Jiangxi Province,Ganzhou450000,China;Department of Pathology,Ganzhou People's Hospital in Jiangxi Province,Ganzhou450000,China)

机构地区：[1]江西省赣州市人民医院儿科,江西赣州450000 [2]江西省赣州市人民医院病理科,江西赣州450000

出　　处：《中国现代医生》2019年第35期69-71,74,共4页China Modern Doctor

基　　金：江西省卫生计生委科技计划（20187243）

摘　　要：目的研究不同种类糖皮质激素治疗儿童原发性肾病综合征的疗效及不良反应。方法选取我院2017年7月~2018年7月收治的初治原发性肾病综合征患儿40例作为研究对象,根据随机数字表法分为醋酸泼尼松组和甲泼尼龙组,每组20例,统计分析两组患儿的激素疗效、不良反应发生情况、尿蛋白转阴时间。结果甲泼尼龙组患儿的激素敏感率[95.0%(19/20)]显著高于醋酸泼尼松组[80.0%(16/20)](P<0.05),复发率、频复发率[65.0%(13/20)、30.0%(6/20)]均显著低于醋酸泼尼松组[80.0%(16/20)、45.0%(9/20)](P<0.05)。甲泼尼龙组患儿的多毛、兴奋表现、柯兴综合征发生率[40.0%(8/20)、90.0%(18/20)、70.0%(14/20)]均显著高于醋酸波尼松组[15.0%(3/20)、20.0%(4/20)、45.0%(9/20)](P<0.05)。甲泼尼龙组患儿的尿蛋白转阴时间显著短于醋酸泼尼松组(P<0.05)。结论甲泼尼龙治疗儿童原发性肾病综合征疗效较醋酸泼尼松显著,能有效缩短患儿的尿蛋白转阴时间,但不良反应较多。Objective To study the efficacy and adverse reactions of different types of glucocorticoids in the treatment of children with primary nephrotic syndrome.Methods Forty children with initially treated primary nephrotic syndrome who were admitted to our hospital from July 2017 to July 2018 were enrolled in the study.According to the random number table method,they were divided into prednisone acetate group and methylprednisolone group,with 20 patients in each group.The hormonal efficacy,adverse reactions,and urinary protein converted negativeconverted time in the two groups were statistically analyzed.Results The hormone sensitivity rate of children in the methylprednisolone group was 95.0%(19/20),which was significantly higher than 80.0%(16/20)in the prednisone acetate group(P<0.05).The recurrence rate and frequency recurrence rate were 65.0%(13/20)and 30.0%(6/20),which were significantly lower than 80.0%(16/20)and 45.0%(9/20)of the prednisone acetate group(P<0.05).The incidence of hairy,excitatory,and Cushing's syndrome in children with methylprednisolone was 40.0%(8/20),90.0%(18/20),and 70.0%(14/20),which were significantly higher than 15.0%(3/20),20.0%(4/20),45.0%(9/20)in the prednisone acetate group(P<0.05).The urinary protein converted negativeconverted time was significantly shorter in the methylprednisolone group than that in the prednisone acetate group(P<0.05).Conclusion The effect of methylprednisolone in the treatment of children with primary nephrotic syndrome is more significant than that of prednisone acetate.Methylprednisolone can effectively shorten the urinary protein converted negativeconverted time of children more effectively,but it has more adverse reactions.

关 键 词：醋酸泼尼松 甲泼尼龙 儿童原发性肾病综合征 不良反应 

分 类 号：R726.9[医药卫生—儿科]