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目的观察泼尼松联合霉酚酸酯治疗儿童紫癜性肾炎的临床疗效。方法选择2009年2月至2011年1月明确诊断为紫癜性肾炎的患儿30例,所有患儿均予泼尼松和霉酚酸酯口服,观察患儿尿常规,尿蛋白定量,尿红细胞形态,血浆白蛋白,血尿素氮,血肌酐等指标的变化。并定期监测血常规,肝功能,感染等指标。结果治疗3个月时完全缓解16例,部分缓解10例;6个月时完全缓解21例,部分缓解7例;8个月时完全缓解24例,部分缓解4例;治疗3个月时患儿尿蛋白下降已非常明显(P<0.05),6个月和8个月时患儿尿蛋白下降更为显著(P<0.01);治疗3个月时30例中6例肉眼血尿已消失,6个月时18例镜下血尿消失;治疗3个月时30例血尿素氮、血肌酐均恢复正常;30例均未见肝功能异常。结论泼尼松联合霉酚酸酯治疗儿童紫癜性肾炎有很好的疗效,不良反应也较小,但因其在临床上应用时间并不长,远期疗效尚待观察。
Objective To observe the clinical efficacy of prednisone combined with mycophenolate mofetil in the treatment of purpuric nephritis in children. Methods Thirty cases of children diagnosed as purpuric nephritis were selected from February 2009 to January 2011. All children were given oral prednisone and mycophenolate mofetil orally. The urinary routine, urinary protein, urinary red blood cells Morphology, serum albumin, blood urea nitrogen, serum creatinine and other indicators of change. And regular monitoring of blood, liver function, infection and other indicators. Results At the end of 3 months, 16 cases were completely relieved and 10 cases partially relieved. 21 cases were relieved at 6 months and 7 cases were partially relieved. 24 cases were relieved at 8 months and 4 cases were partially relieved. After 3 months of treatment The decrease of urinary protein was very significant (P <0.05), and the urinary protein decreased more significantly in 6 months and 8 months (P <0.01). At 3 months, 6 cases of gross hematuria disappeared in 30 cases, At 6 months, 18 cases of hematuria disappeared under microscope; 30 cases of blood urea nitrogen and serum creatinine returned to normal after 3 months of treatment; no abnormal liver function was found in 30 cases. Conclusion Prednisone combined with mycophenolate mofetil in children with purpura nephritis has a good effect, adverse reactions are small, but because of its clinical application of time is not long, the long-term efficacy remains to be seen.