严晓宇+李春华+龚先明

[摘要] 目的 探讨肾病综合征患儿采取甲泼尼龙冲击治疗与传统口服足量泼尼松治疗的临床疗效及安全性差异。 方法 选取本院儿科2010年4月~2013年12月收治的42例原发性肾病综合征患儿，随机分为研究组和对照组，每组21例。其中研究组采用甲泼尼龙冲击治疗，对照组采用口服足量的泼尼松进行治疗。记录两组的尿蛋白转阴时间、体质量、皮下脂肪厚度、身高及骨密度水平。 结果 研究组尿蛋白转阴时间短于对照组，差异有统计学意义（P<0.05）。治疗后3个月的体质量和皮下脂肪厚度，对照组较治疗前增加（P<0.05），身高和骨密度两组治疗前后差异无统计学意义（P＞0.05）。 结论 对于激素敏感性肾病综合征患儿，给予甲泼尼龙冲击治疗相较于口服足量泼尼松，能使尿蛋白更快转阴，并对患儿体质量及皮下脂肪的影响更小，但可能于治疗期间出现感染等不良事件。

[关键词] 小儿激素敏感肾病；甲泼尼龙；冲击治疗

[中图分类号] R726.9[文献标识码] A[文章编号] 1674-4721（2014）04（c）-0063-03

Effect observation of methylprednisolone shock treatment for children with steroid sensitive nephrotic syndrome

YAN Xiao-yu1LI Chun-hua2GONG Xian-ming2

1.Xiaojinkou People′s Hospital of Huizhou City in Guangdong Province,Huizhou 516023,China;2.The Third People′s Hospital of Huizhou City in Guangdong Province,Huizhou 516001,China

[Abstract] Objective To explore the clinical efficacy and safety of methylprednisolone shock treatment and traditional oral prednisone treatment on patients with steroid sensitive nephrotic.Methods 42 cases of primary nephrotic syndrome in children in our hospital from April 2010 to December 2013 were selected,and were divided into research group and control group randomly,21 patients in each group.The research group were carried out the methylprednisolone pulse therapy,the control group were carried out oral prednisone therapy enough.The urinary protein clearance time,body weight,subcutaneous fat thickness,height and bone density was recorded and compared in two groups.Results The urine protein negative time in research group was shorter than that in the control group,the difference was significant (P<0.05).3 months after treatment,body mass and subcutaneous fat thickness in control group was increased compared with before treatment (P<0.05); height and bone density before and after treatment in the two groups had no significant difference (P＞0.05).Conclusion For the steroid sensitive nephrotic syndrome in children,methylprednisolone pulse therapy compared with oral dose prednisone can make the urine protein negative influence on faster,and children with body weight and fat less,but may in the treatment of infection and other adverse events.

[Key words] Children with steroid sensitive nephrotic;Methylprednisolone;Shock treatment

肾病综合征是儿科病房常见的肾脏疾病，主要好发于2~12岁儿童，以肾小球病变为主，目前在临床上主要以激素治疗为主[1]。虽然长时间服用激素能使患儿病情得到有效缓解，但对于正处于生长发育阶段的儿童而言，无疑会增加不可预期并发症的发生率，最后增加治疗难度，不利于病情预后康复[2]。因此，针对该病的临床诊疗方案已然成为国内外专家学者所关注的热门课题。据文献报道[3]，利用甲泼尼龙冲击治疗方案能达到快速缓解患者临床症状的目的，进而随着应用时间的缩短降低并发症的发生率。……