丙种球蛋白联合雷公藤多苷治疗儿童过敏性紫癜性肾炎的效果及对尿蛋白、尿红细胞的影响

目的观察丙种球蛋白联合雷公藤多苷治疗儿童过敏性紫癜性肾炎的效果及对尿蛋白、尿红细胞的影响。方法选取2017年2月-2019年1月海南医学院第二附属医院儿科诊治过敏性紫癜性肾炎患儿64例作为研究对象,按照随机数字表法分为2组,每组32例。2组均予常规处理,对照组另予丙种球蛋白静脉注射,观察组在丙种球蛋白静脉注射基础上联合雷公藤多苷口服。治疗14 d后比较2组患儿的临床疗效、凝血功能、尿蛋白、尿红细胞、免疫水平及不良反应发生情况。结果治疗后,观察组总有效率为96.88%,高于对照组的68.75%(χ2/P=8.892/0.003);观察组血浆D-二聚体(D-D)、纤维蛋白原(Fib)水平低于对照组,而活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)长于对照组(t/P=5.712/<0.001、14.223/<0.001、-28.284/<0.001、-4.380/<0.001);观察组IgA、IgA1水平均低于对照组(t/P=6.893/<0.001、6.690/<0.001);观察组尿红细胞计数、24 h尿蛋白、尿微量白蛋白、尿β2微球蛋白水平均低于对照组(t/P=110.061/<0.001、12.008/<0.001、16.880/<0.001、4.444/<0.001);2组患儿均未出现严重药物不良反应。结论采用丙种球蛋白联合雷公藤多苷治疗儿童过敏性紫癜性肾炎,能够有效改善肾功能凝血功能、免疫功能,降低尿蛋白、尿红细胞水平,临床治疗效果较好,且安全性较高。

The effect of gamma globulin combined with tripterygium wilfordii glycoside on children with Henoch-Schonlein purpura nephritis

Objective To observe the effect of gamma globulin combined with tripterygium wilfordii glycoside in the treatment of Henoch Schonlein purpura nephritis in children and its effect on urinary protein and RBC.Methods From February 2017 to January 2019,64 children with Henoch-Schonlein purpura nephritis were selected as the study object.According to the method of random number table,they were divided into two groups,32 cases in each group.The two groups were given routine treatment,the control group was given another intravenous injection of gamma globulin,the observation group was combined with tripterygium glycoside based on intravenous injection of gamma globulin.After 14 days of treatment,the clinical effect,coagulation function,urinary protein,urinary RBC,immune level and adverse reactions of the two groups were compared.Results After treatment,the total effective rate in the observation group was 96.88%,which was higher than the control group’s 68.75%(χ2/P-8.892/0.003).The levels of plasma D-dimer(D-D) and fibrinogen(Fib) in the observation group were lower than those in the control group,while the activated partial thromboplastin time(APTT) and prothrombin time(PT) were longer than those in the control group(t/P=5.712/<0.001,14.223/<0.001,-28.284/<0.001,-4.380/<0.001).The levels of IgA and IgAl in the observation group were lower than those in the control group(t/P=6.893/<0.001,6.690/<0.001).The levels of urinary red blood cell count,24-hour urinary protein,urinary microalbumin,and urinary β2 microglobulin in the observation group were lower than those in the control group(t/P=110.061/<0.001,12.008/<0.001,16.880/<0.001,4.444/<0.001).There were no serious adverse drug reactions in the two groups.Conclusion The treatment of children’s Henoch-Schonlein purpura nephritis with immunoglobulin and tripterygium wilfordii glycoside can effectively improve the coagulation function and immune function of renal function,reduce the level of urine protein and urine red blood cell.The clinical treatment effect is good and the safety is high.