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目的观察苯那普利(Benazepril)与泼尼松合用治疗原发性肾病综合征(单纯型PNS)的临床疗效及治疗前后血清瘦素(Ieptin,LP)水平的变化。方法选择PNS(单纯型)患儿60例,按照随机数字表法分为治疗组32例和对照组28例,对照组采用泼尼松(Predisone)中疗程法,治疗组在对照组基础上加用苯那普利(Benazepril)5岁以下3mg/d,7岁以下5mg,10岁以下7mg,1次/d,研究观察疗程为12周,两组均在治疗前、后4、8、12周的临床疗效及蛋白尿、血浆白蛋白(AIb)、血胆固醇(TC)及LP指标的变化,治疗结束后继续随访2年进行两组病情反复或复发率的观察。结果治疗组临床疗效优于对照组(P<0.05),病情反复及复发率治疗组明显低于对照组(P<0.05),LP变化与尿蛋白及TC呈负相关),与血浆白蛋白(AIb)呈正相关(P<0.01和P<0.05)。结论苯那普利(Benazepril)与泼尼松合用可稳定因泼尼松引起的高血压,改善肾血流量和肾滤过膜功能,增强临床疗效,缩短最佳有效疗程时间,稳定疗效作用,有效降低LP水平,减少糖皮质激素副反应的作用。
Objective To observe the clinical efficacy of Benazepril in combination with prednisone in the treatment of primary nephrotic syndrome (PNS) and the changes of serum leptin (Ieptin, LP) before and after treatment. Methods Sixty children with PNS (simple type) were randomly divided into treatment group (32 cases) and control group (28 cases). Prednisone treatment group Benazepril (Benazepril) under 5 years of age 3mg / d, 7 years of age 5mg, 10 years of age 7mg, 1 / d, the study observed for 12 weeks, both before treatment, after 4,8,12 Week clinical efficacy and proteinuria, plasma albumin (AIb), blood cholesterol (TC) and LP changes in the index, the treatment was followed up for 2 years to observe the recurrence or recurrence rate of the two groups were observed. Results The clinical efficacy of the treatment group was better than that of the control group (P <0.05). The incidence of relapse and recurrence in the treatment group was significantly lower than that in the control group (P <0.05), and the changes of LP were negatively correlated with urine protein and TC) AIb) (P <0.01 and P <0.05). Conclusions Benazepril combined with prednisone can stabilize hypertension caused by prednisone, improve renal blood flow and renal filtration membrane function, enhance clinical curative effect, shorten the optimal and effective course of treatment time, stabilize the curative effect, Effectively reduce the level of LP and reduce the side effects of glucocorticoids.