甲基强的松龙冲击治疗难治性肾病综合征疗效分析
作者：李波 冯慕仁 何岳林
单位：李波 冯慕仁(563002 贵州省遵义医院儿科)；何岳林(广州南方医院儿科)
关键词：肾病综合征；甲基强的松龙；冲击疗法
中国煤炭工业医学杂志000951摘 要：目的探讨甲基强的松龙冲击疗法对难治性肾病综合征的疗效。方法选择38例难治性肾病综合征患儿，给予甲基强的松龙每次20-30mg/kg，加入10%葡萄糖溶液100ml中静滴、1/d，连用3d，第4-7d口服强的松2mg/(kg·d)。未完全缓解者重复第二疗程。结果冲击治疗后，血浆白蛋白有不同程度的升高，24h尿蛋白定量、血胆固醇、血肌酐(Cr)、尿素氮(BUN)有明显降低，冲击治疗前后相差有高度显著性(P<0.01)。随着MP冲击疗程增加，完全及部分缓解例数增多。结论甲基强的松龙冲击疗法可以使难治性肾病达到较稳定的缓解及保护肾功能，尤其对早期病例效果较好，但必须通过前瞻性对照研究加以证实。 ANALYSIS OF THE CURATIVE EFFECT OF METHYLPREDNISOLONE ICTUS THERAPY FOR REFRACTORY NEPHROTIC SYNDROME
, 百拇医药
Li Bo ,Feng Muren ,He Yuelin
(Zunyi Hospital of Guichou Province, Zunyi 563002)
Abstract：Objective To study the effects of methylprednisolone (MP) pulse therapy on refractory nephrotic syndrome. Methods 38 cases of refractory nephrotic syndrome were selected for the study and 20-30mg/kg of MP added into 100ml of glucose solution (10%) was dripped intravenously once a day for 3 consecutive days followed by oral cortisol 2mg/(kg·d) for 4 days. Those who didn't responded with complete remission were treated again. Results After MP pulse therapy, plasma albumim was increased to different degrees, while 24h urine protein, serum cholesterol level, SCR and BUN determination was obviously decreased. The effects before and after the therapy were significantly different (P<0. 01). Conclusion This retrospective study suggests that MP pulse therapy may induce a more stable remission of refractory nephrotic syndrome and may better protect renal function, especially if started earlier during the course of the disease. However, these results must be confirmed by a prospective controlled trial.
, 百拇医药
Keywords：Nephrotic syndrome Methylprednisone Ictus therapy
参考文献：
[1]姜新猷，陈荣华，王宝琳.关于小儿肾小球疾病临床分类和治疗的建议的修订意见.中华儿科杂志，1981，19(4)：241.
[2]MoroniG，MaccarioM，BanfiG，et al. Treatment of membranous lupus nephritis.Am J Kidney Dis，1998，31(4)：681.
[3]Niaudet P，Habib R.Methylprednisolone pulse therapy in the treatment of severe forms of Schonlein-Henoch purpura nephritis.Pediatr Nephrol，1998，12(3)：238.
, 百拇医药
[4]陈树宝，主编.儿科学新理论与新技术.上海：上海科技教育出版社，1997.313.
[5]Walodo FB，Benfield MR，KohautEC.Therapy of focal and segmental glomerulosclerosis with methylprednisolone，Cyclosporine A，and prednisone.Pediatr nephrol，1998，12(5)：397.
[6]PonticelliC，VillaM，BanfiG，et al.Can prolonged treatnent improve the prognosis in adults with focal segmental glomerulosclerosis，Am J Kidney Dis，1999，34(4)：618.
[7]PonticelliC，AltieriP，ScolariF，et al.Arandomized stuay comparing methylprednisolone plus chlorambucil versus methylprednisolone plus cyclophosphamide in idioplathic membranous nephropathy，J Am soc Nephrol.1998，9(3)：444.
[8]张建涛.甲基强的松龙冲击疗法后即刻肾功能变化的观察.实用医学杂志，1998，14(2)：8l-82.
[9]陈握龄.甲基强的松龙冲击治疗小儿难治性肾病综合征.广州医药，1994，25(2)：25.
收稿日期：2000-03-30
修稿日期：2000-06-19, 百拇医药
单位：李波 冯慕仁(563002 贵州省遵义医院儿科)；何岳林(广州南方医院儿科)
关键词：肾病综合征；甲基强的松龙；冲击疗法
中国煤炭工业医学杂志000951摘 要：目的探讨甲基强的松龙冲击疗法对难治性肾病综合征的疗效。方法选择38例难治性肾病综合征患儿，给予甲基强的松龙每次20-30mg/kg，加入10%葡萄糖溶液100ml中静滴、1/d，连用3d，第4-7d口服强的松2mg/(kg·d)。未完全缓解者重复第二疗程。结果冲击治疗后，血浆白蛋白有不同程度的升高，24h尿蛋白定量、血胆固醇、血肌酐(Cr)、尿素氮(BUN)有明显降低，冲击治疗前后相差有高度显著性(P<0.01)。随着MP冲击疗程增加，完全及部分缓解例数增多。结论甲基强的松龙冲击疗法可以使难治性肾病达到较稳定的缓解及保护肾功能，尤其对早期病例效果较好，但必须通过前瞻性对照研究加以证实。 ANALYSIS OF THE CURATIVE EFFECT OF METHYLPREDNISOLONE ICTUS THERAPY FOR REFRACTORY NEPHROTIC SYNDROME
, 百拇医药
Li Bo ,Feng Muren ,He Yuelin
(Zunyi Hospital of Guichou Province, Zunyi 563002)
Abstract：Objective To study the effects of methylprednisolone (MP) pulse therapy on refractory nephrotic syndrome. Methods 38 cases of refractory nephrotic syndrome were selected for the study and 20-30mg/kg of MP added into 100ml of glucose solution (10%) was dripped intravenously once a day for 3 consecutive days followed by oral cortisol 2mg/(kg·d) for 4 days. Those who didn't responded with complete remission were treated again. Results After MP pulse therapy, plasma albumim was increased to different degrees, while 24h urine protein, serum cholesterol level, SCR and BUN determination was obviously decreased. The effects before and after the therapy were significantly different (P<0. 01). Conclusion This retrospective study suggests that MP pulse therapy may induce a more stable remission of refractory nephrotic syndrome and may better protect renal function, especially if started earlier during the course of the disease. However, these results must be confirmed by a prospective controlled trial.
, 百拇医药
Keywords：Nephrotic syndrome Methylprednisone Ictus therapy
参考文献：
[1]姜新猷，陈荣华，王宝琳.关于小儿肾小球疾病临床分类和治疗的建议的修订意见.中华儿科杂志，1981，19(4)：241.
[2]MoroniG，MaccarioM，BanfiG，et al. Treatment of membranous lupus nephritis.Am J Kidney Dis，1998，31(4)：681.
[3]Niaudet P，Habib R.Methylprednisolone pulse therapy in the treatment of severe forms of Schonlein-Henoch purpura nephritis.Pediatr Nephrol，1998，12(3)：238.
, 百拇医药
[4]陈树宝，主编.儿科学新理论与新技术.上海：上海科技教育出版社，1997.313.
[5]Walodo FB，Benfield MR，KohautEC.Therapy of focal and segmental glomerulosclerosis with methylprednisolone，Cyclosporine A，and prednisone.Pediatr nephrol，1998，12(5)：397.
[6]PonticelliC，VillaM，BanfiG，et al.Can prolonged treatnent improve the prognosis in adults with focal segmental glomerulosclerosis，Am J Kidney Dis，1999，34(4)：618.
[7]PonticelliC，AltieriP，ScolariF，et al.Arandomized stuay comparing methylprednisolone plus chlorambucil versus methylprednisolone plus cyclophosphamide in idioplathic membranous nephropathy，J Am soc Nephrol.1998，9(3)：444.
[8]张建涛.甲基强的松龙冲击疗法后即刻肾功能变化的观察.实用医学杂志，1998，14(2)：8l-82.
[9]陈握龄.甲基强的松龙冲击治疗小儿难治性肾病综合征.广州医药，1994，25(2)：25.
收稿日期：2000-03-30
修稿日期：2000-06-19, 百拇医药