摘要
目的：探讨原发性肾病综合征（PNS）合并慢性肾功能不全患者应用糖皮质激素联合免疫抑制剂等药物的疗效及副作用，以期为临床上治疗此类疾病提供安全、有效的治疗方法。方法对2007年12月至2012年6月在解放军第148医院肾内科住院、诊断明确、临床资料完整、入院前未经系统、正规治疗的PNS伴肾功能不全患者50例进行回顾性分析。将患者分为免疫抑制治疗组及常规对症治疗组，观察两组治疗前及治疗后1，3，6，12个月时24h尿蛋白定量、血清白蛋白和血清肌酐等指标变化，并进行对比分析。结果免疫抑制治疗组的24h尿蛋白定量在治疗1，3，6及12个月时均显著减少；估算肾小球滤过率（eGFR）在治疗后3，6，12个月时均显著升高；而常规对症治疗组的上述两项指标在治疗12个月时变化仍不明显。免疫抑制治疗组与常规对症治疗组在药物副作用的观察方面有差异，但无统计学意义。结论对伴有一定程度慢性肾功能不全PNS患者，糖皮质激素和免疫抑制剂治疗可明显减少尿蛋白，改善eGFR，延缓肾功能恶化。
Objective To investigate the therapeutic efficiency and side effects of glucocorticoids combined with immunosuppressants for the cases of primary nephrotic syndrome with chronic renal failure in order to provide safe and efficient treatment in clinical practice. Methods A total of 50 patients with identified primary nephrotic syndrome with chronic renal failure in No.148 Hospital of Chinese PLA from December 2007 to June 2012 were enrolled in this retrospective study. All the patients were divided into 2 groups： the immunosuppressive treatment group and the conventional treatment group. The serum levels of albumin and cretinine, the 24-hour urine protein and the side effects were analyzed before and in 1, 3, 6, and 12 months after treatment respectively. Results In the patients of immunosuppressive treatment group, the level of 24-hour urine protein was significantly reduced in 1, 3, 6 and 12 months after the treatment. Meanwhile, the level of estimated glomerular filtration rate （eGFR） was increased significantly in 3, 6 and 12 months after the treatment. However, the level of 24-hour urine protein and the eGFR had no significant change in the conventional treatment group after 12 months treatment. There were differences in the side effects between the 2 groups, but without significant difference. Conclusion The combined treatment with glucocorticoids and immunosuppressants obviously reduces urinary protein, improves renal function, and delays the development of renal failure in PNS patients with chronic renal failure.
出处
《中华老年多器官疾病杂志》
2014年第2期119-122,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
肾病综合征
糖皮质激素类
免疫抑制剂
肾功能不全
慢性
nephrotic syndrome
glucocorticoids
immunosuppressive agents
renal insufficiency,chronic
