贺斯治疗高度水肿伴尿少的原发性肾病综合征的临床观察

目的观察高度水肿伴尿少的原发性肾病综合征患者，加用贺斯（6％羟乙基淀粉）治疗后，是否有利于其水肿、尿少等临床症状的缓解。方法原发性肾病综合征患者69例，分为贺斯组和对照组。对照组常规使用糖皮质激素，抗凝、利尿等药物治疗，贺斯组在此基础上加用贺斯治疗。观察治疗前、后24h尿量、平均动脉压、血清蛋白、ALT、尿素氮、肌酐、血钾及血钠等生化指标的变化。结果两组治疗后24h尿量与治疗前比较差异均有显著性意义（P〈0．01）。治疗后，两组24h尿量间差异有显著性意义（P〈0．05）。其余各项指标治疗前后组间与组内比较，差异均无显著性意义（P〉0．05）。结论贺斯在高度水肿伴尿少的原发性肾病综合征的治疗中有一定作用。通过扩容对利尿、消肿、缓解临床症状等均起到了积极的作用，为进一步的综合治疗提供了有利条件。

Treatment of Primary Nephrotic Syndrome with Serious Edema and Oliguria with HAES-steril

Objective To observe whether the clinical symptoms such as edema and oliguria can be relieved in patients with primary nephrotic syndrome treated with HAES-steril.Methods Totally 69 patients with primary nephrotic syndrome were at random divided into two groups: control group was regularly administrated glucocorticoid,anticoagulated and diureses;and HAES group was given HAES-steril besides the same treatment as control group.The changes were observed of 24 hours urinary production,mean arterial blood pressure,serum albumin,glutamate pyruvate transaminase,urea nitrogen,creatinin,serum kalium and serum natrium in two groups before and after treatment.Results The mean levels of 24 hours urinary production in two groups were significantly higher than those before treatment (P<0.01),the mean level of 24 hours urinary production in HAES group after treatment was significantly higher than that in control group after treatment (P<0.05),and the mean arterial blood pressure,serum albumin,glutamate pyruvate transaminase,urea nitrogen,creatinin,serum kalium and serum natrium in two groups were no significantly difference (P>0.05).Conclusion The results confirms that HAES-steril was effective in treating primary nephrotic syndrome with serious edema and oliguria.It has active actions in diureses,detumescence and relieving symptoms by plasma volume expansion,providing an advantageous condition for comprehensive therapy.