小剂量泼尼松治疗老年肾病综合征的临床探讨  

Clinical Study of Low Dose Prednisone in the Treatment of Nephrotic Syndrome in the Elderly

作　　者：彭小燕 PENG Xiaoyan(Department of Geriatrics,Jincheng People's Hospital,Jincheng,Shanxi Province,048000 China)

机构地区：[1]晋城市人民医院老年医学科,山西晋城048000

出　　处：《中外医疗》2022年第34期112-116,共5页China & Foreign Medical Treatment

摘　　要：目的探究小剂量泼尼松治疗老年肾病综合征的临床效果。方法方便选取2019年10月-2020年12月晋城市人民医院收治的66例老年肾病综合征患者,随机分成两组,每组33例。在入院后均接受抗凝、调脂和利尿等常规对症治疗的基础上,对照组接受常规剂量的泼尼松治疗,研究组则接受小剂量泼尼松治疗。对比两组患者的临床治疗效果、各项临床指标及不良反应发生情况。结果研究组的临床治疗效果(93.9%)优于对照组(72.7%),差异有统计学意义(χ^(2)=5.345,P<0.05)。研究组在治疗后4周、24周的尿蛋白(2.0±0.2)、(1.0±0.2)g/d,血浆白蛋白(31.0±0.1)、(39.8±1.0)g/L,血清肌酐(96.3±2.4)、(64.2±1.0)μmol/L,均优于对照组,差异有统计学意义(P<0.05);与对照组(24.2%)相比,研究组白细胞减少、血小板减少等不良反应的发生率(6.1%)更低,差异有统计学意义(χ^(2)=4.243,P<0.05)。结论应用小剂量泼尼松治疗可以有效缓解或消除水肿、蛋白尿等临床症状,剂量的减少可以在保障治疗有效性的同时降低不良反应发生率,优化各项肾功能指标,进而保障老年肾病综合征患者在治疗期间的安全性,效果显著。Objective To explore the clinical effect of low dose prednisone in the treatment of nephrotic syndrome in the elderly.Methods Conveniently select Sixty-six elderly patients with nephrotic syndrome admitted to Jincheng People's Hospital from October 2019 to December 2020 were randomly divided into two groups,with 33 patients in each group.After admission,all patients received conventional symptomatic treatment such as anticoagulation,lipid regulation and diuresis.The control group received conventional dose of prednisone,while the study group received low dose of prednisone.The clinical therapeutic effect,clinical indexes and the occurrence of adverse reactions were compared between the two groups.Results The clinical treatment effect of the study group(93.9%)was better than that of the control group(72.7%),and the difference was statistically significant(χ^(2)=5.345,P<0.05).The urine protein(2.0±0.2)g/d,(1.0±0.2)g/d,plasma albumin(31.0±0.1)g/L,(39.8±1.0)g/L,serum creatinine(96.3±2.4)μmol/L,and(64.2±1.0)μmol/L in the study group were significantly better than those in the control group at the 4 weeks and 24 weeks after treatment,and the difference was statistically significant(P<0.05).Compared with the control group(24.2%),the incidence of adverse reactions such as leukopenia and thrombocytopenia in the study group(6.1%)was lower,and the difference was statistically significant(χ^(2)=4.243,P<0.05).Conclusion The application of low dose prednisone treatment can effectively relieve or eliminate clinical symptoms such as edema and albuminuria.Dose reduction can ensure the effectiveness of treatment while reducing the incidence of adverse reactions,optimize various renal function indicators,and thus guarantee the safety of elderly patients with nephrotic syndrome during treatment,with significant effect.

关 键 词：小剂量泼尼松 老年肾病综合征 临床效果 尿蛋白 血浆白蛋白 不良反应 

分 类 号：R592[医药卫生—老年医学]