肾病综合征不同治疗方案疗效的对比研究

目的:比较不同肾上腺糖皮质激素单独应用及激素与不同免疫抑制剂联合应用治疗原发性肾病综合征(PNS)的疗效。方法:140例原发性肾病综合症患者按所选治疗药物及方案不同分为6组,分别给予单独强的松口服、单独甲基强的松龙静点、强的松分别与长春新碱、环磷酰胺、来氟米特、雷公藤多甙合用,观察疗效及部分生化指标。结果:①原发性肾病综合征不同治疗方案之间末次随访时缓解率无明显差异,但达到缓解所需时间各不相同。①强的松口服治疗与甲基强的松龙静点治疗2组达到缓解所需时间存在显著性差异(P<0.001),前者所需时间较后者平均长13.1d,甲基强的松龙静点组治疗后血清白蛋白增长情况及24h尿蛋白减少情况均明显优于强的松口服组。③糖皮质激素与免疫抑制剂联合应用达到缓解所需时间较单用糖皮质激素治疗达到缓解所需时间平均短1￣3周,且前者治疗后血清白蛋白增长及24h尿蛋白减少情况明显优于后者。结论:在原发性肾病综合征的各种治疗方案中,糖皮质激素与长春新碱联合治疗最安全、最有效。

The contrastive study on the efficacy of different therapy in nephrotic syndrome

Objective To compare the efficacy of different therapy in primary nephrotic syndrome. Method 140 patients with primary nephrotic syndrome were allocated into six groups,they were administrated oral prednisone,intravenous methylprednisolone,prednisone combined vincristine, combined cyclophosphamide, combined leflunomide, combined wilfordine respectively.The clinical and laboratory data were compared. Results The remission rates of different therapy were not obviously different in primary nephrotic syndrome. But the time to acquire remission was different.The time to acquire remission existed remarkable diversity between oral prednisone group and intravenous methylprednisolone group, the former was longer than the latter.The time to acquire remission was different between corticosteroid combined immunosuppressive agents groups and only corticosteroid groups, the former was shorter than the latter. Conclusion Among all therapeutic groups, the therapy of corticosteroid combined vincristine is the most safe and effective.