尿脱氧吡啶啉对评价肾病综合征患儿泼尼松治疗后骨吸收异常的价值及肾康灵的干预作用

目的：（1）通过观察肾病综合征（NS）患儿尿脱氧吡啶啉（DPD）排泄率的变化,探讨用尿脱氧吡啶啉来评价泼尼松治疗肾病综合征患儿骨吸收异常的价值。（2）观察肾病综合征患儿肾康灵治疗前后DPD排泄率的变化,探讨肾康灵治疗激素性骨质疏松的疗效。方法：（1）以30例NS患儿为研究对象,在足量泼尼松治疗前及治疗后6周分别留取尿标本检测尿DPD排泄率。（2）30例患儿在泼尼松足量治疗后6周随机分为治疗组、对照组。对照组继续足量泼尼松治疗,治疗组在对照组的基础上加用中药复方肾康灵冲剂口服治疗,2周后留取尿标本检测尿DPD排泄率。结果：泼尼松足量治疗6周后尿DPD排泄率明显高于激素治疗前（P〈0.01）。（2）泼尼松足量治疗8周后治疗组与对照组相比较,尿DPD排泄率明显降低,两者比较有统计学差异（P〈0.05）。结论：（1）泼尼松治疗肾病综合征的患儿尿DPD排泄增加,支持了激素可导致骨吸收增加的观点。（2）肾康灵能显著降低肾病综合征的患儿尿DPD的排泄,提示其治疗激素性骨质疏松有一定益处,其抗骨质疏松作用可能通过多个途径而实现。

Urinary Deoxypyridinoline Excretion Rate for Evaluating the Impaired Bone Resorption in Children with Nephritic Syndrome and the Effect of Prednisone and the Shenkangling Treatment

Objective:(1)To investigate the value of Deoxypyridinoline (DPD) excretion rate in determining the impaired bone resorption in NS children treated with prednisone. (2)To investigate the therapeutic effect of Shenkangling on osteoporosis caused by prednisone.Methods:(1) 30 NS children were enrolled in the study and the DPD excretion rate in the urine samples was tested before and after full-dosage prednisone treatment for 6 weeks.(2)At the end of the full-dosage prednisone treatment, 30 NS children were randomly divided into treatment group and control group. Prednisone treatment continued in control group and the combination treatment of prednisone and Shenkangling was admitted to treatment group.The DPD excretion rate in urine samples were tested 2 weeks after the treatment.Results:(1) The DPD excretion rate in urine sample was higher after 6 weeks of full-dosage of prednisone than that of the pre-treatment,(P<0.01. (2) At the end of the 8-week investigation, the DPD excretion rate of the treatment group was significantly lower than that of the control group (P<0.05).Conclusion:(1) Ful-dosage of prednisone increases DPD excretion rate in urine sample indicating that bone resorption is increased. (2)Shenkangling can decrease DPD excretion rate of NS children, indicates that it might be beneficial for osteoporosis induced by prednisone.