糖皮质激素治疗原发性肾病综合征合并结核性胸膜炎疗效观察

目的观察糖皮质激素治疗原发性肾病综合征(PNS)合并结核性胸膜炎的疗效。方法我院2007年12月—2011年12月收治的11例PNS合并结核性胸膜炎患者,给予泼尼松、盐酸贝那普利、补钙、抗血小板聚集等治疗8周,8周后糖皮质激素改为隔日疗法;同时给予标准抗结核化疗方案治疗。观察治疗4周、8周后24 h尿蛋白定量、血浆清蛋白、水肿变化情况及体温、血沉、胸部X线、B超等指标变化。结果治疗8周后,7例患者PNS症状完全缓解,3例部分缓解,1例未缓解;结核性胸膜炎症状均完全好转或部分好转,无未好转者。患者水肿逐渐消失,体温恢复正常,结核中毒症状缓解,胸部X线及B超显示胸腔积液消失,24 h尿蛋白定量逐渐减少,血浆清蛋白水平升高,血沉逐渐恢复正常。结论糖皮质激素治疗PNS合并结核性胸膜炎效果明显,配合标准抗结核化疗方案,对结核性胸膜炎结核中毒症状的改善有协同作用,提高了临床疗效。

Glucocorticoid in Treatment of Primary Nephrotic Syndrome Combined with Tuberculous Pleurisy

Objective To observe the effect of Glucocorticoid on primary nephrotic syndrome(PNS)combined with tuberculous pleurisy.Methods Eleven patients with PNS accompanied by tuberculous pleurisy were administered prednisone,benazepril hydrochloride,calcium,anti-platelet aggregation.After 8 weeks given alternate day therapy of glucocorticoid and meanwhile standard anti-TB chemotherapy.24 h urinary protein excretion,plasma albumin,edema,and temperature,erythrocyte sedimentation,chest X-ray,ultrasonic B and other indexes were observed after 4 weeks and 8 weeks of treatment.Results After 8 weeks,complete remission of PNS symptom was noted in 7 patients,partial in 3,no remission in 1.Tuberculous pleurisy symptoms fully recovered or partially in all patients.Edema gradually disappeared,body temperature returned to normal,poisoning eased,chest X-ray and ultrasound showed disappearance of pleural effusion,24 h urinary protein excretion gradually reduced,plasma albumin level elevated,erythrocyte sedimentation returned to normal.Conclusion Glucocorticoid,having remarkable effects on PNS combined with tuberculous pleurisy,is safe and effective.