甲基强的松龙和强的松治疗儿童肾病综合征伴急性肾衰的疗效比较研究

目的:观察儿童肾病综合征合并急性肾功能衰竭的临床特点,比较甲基强的松龙冲击疗法与足量强的松疗法的效果。方法:以1992年6月至2005年12月我院收治的肾病综合征合并急性肾功能衰竭患儿为研究对象,共61例。其中2002年1月至2005年12月共33例,为治疗组,采用甲基强的松龙冲击治疗;1992年6月至2001年12月共28例,为对照组,采用足量强的松口服治疗。结果:两组疗效及尿蛋白阴转时间无显著性差异(P>0.05),预后基本相同,但甲基强的松龙组的副作用及治疗费用较高。结论:甲基强的松龙冲击治疗原发性肾病综合征合并急性肾功能衰竭与口服足量强的松治疗相比,疗效无显著差别,但医疗费用明显增高,且治疗期间可能出现不良反应,需谨慎使用,其有效性及安全性有待进一步研究加以证实。

Comparison of effects of treatment of nephritic syndrome in children with acute renal failure with methylprednisolone and prednisone

Objective:To observe the clinical characteristics of nephritic syndrome in children with acute renal failure and to compare the effects of methylprednisolone(MP)pulse therapy with that of prednison comman therapy.Methods:61 children with nephritic syndrome complicated with acute renal failure were selected who were in our hospital from June,1992 to December,2005.They were divided into control group(n=28)who were in our hospital from June,1992 to December,2001 and treated with oral prednisone therapy and MP group(n=33)who were in our hospital from January,2002 to December,2005 and treated with methylprednisolone pulse therapy.The therapeutic outcome of both groups were compared each other.Results:There were not any significant difference of therapeutic outcome and the darkening time of urine protein between two groups(P>0.05),and the prognosis of both groups was similar.But the incidence of side-effects and medical cost of the MP group were higher than those of the control group.Conclusion:The effect of methylprednisolone pulse therapy on idiopathic nephritic syndrome with acute renal failure in children is similar to adequate oral prednisone therapy,but it needs more medical costs and has more side-effects.Therefore,the effectiveness and safety of methylprednisolone pulse therapy in children needs studied further.