论文部分内容阅读
目的观察小剂量尿激酶联合激素和坎地沙坦治疗中重型肾病综合征(NS)的临床疗效和安全性。方法选择临床确诊为原发性NS的患者25例,尿蛋白≥3.5 g/24 h,血肌酐(Scr)≤265μmol/L,随机分为治疗组(UK组,n=13)和对照组(control组,n=12),治疗组接受尿激酶、激素和坎地沙坦治疗,对照组接受激素和坎地沙坦治疗,观察期限为4个月。结果①临床缓解率:UK组临床完全缓解率和部分缓解率分别为53.8%和38.5%,control组分别为25.0%和58.3%。两组疗效比较差异有统计学意义(P<0.05)。②与治疗前相比UK组血肌酐明显下降〔(117±23)μmo/L vs(96±12)μmol/L,P<0.05〕,control组血肌酐则变化不大〔(121±23)μmo)/L vs(123±19)μmol/L,P<0.05〕。③两组患者尿蛋白均较治疗前下降,治疗0、2、4个月时UK组尿蛋白分别为(4.38±0.62)g/24 h、(1.59±0.26)g/24 h、(1.15±0.17)g/24 h,control组分别为(4.36±0.56)g/24 h、(2.24±0.29)g/24 h、(1.53±0.21)g/24 h,UK组尿蛋白下降快于control组,差异有统计学意义(P<0.05)。结论小剂量尿激酶联合激素和坎地沙坦能有效改善中重型NS患者的肾功能,减少蛋白尿,治疗效果显著。
Objective To observe the clinical efficacy and safety of low-dose urokinase combined with candesartan in the treatment of moderate-severe nephrotic syndrome (NS). Methods Twenty-five patients with clinically diagnosed primary NS were enrolled in this study. Urinary protein≥3.5 g / 24 h and serum creatinine (Scr) ≤265 μmol / L were randomly divided into treatment group (UK group, n = 13) and control group control group, n = 12). The treatment group was treated with urokinase, hormone and candesartan. The control group was treated with hormone and candesartan. The observation period was 4 months. Results ① The clinical remission rate: The clinical complete remission rate and partial remission rate were 53.8% and 38.5% in the UK group and 25.0% and 58.3% in the control group respectively. The difference between the two groups was statistically significant (P <0.05). ② Serum creatinine in the UK group was significantly lower than that in the UK before treatment (117 ± 23 μmol / L vs 96 ± 12 μmol / L, P <0.05) μmo) / L vs (123 ± 19) μmol / L, P <0.05〕. (3) The proteinuria in both groups decreased compared with before treatment, and the proteinuria in UK group were (4.38 ± 0.62) g / 24 h, (1.59 ± 0.26) g / 24 h, (1.15 ± (4.36 ± 0.56) g / 24 h, (2.24 ± 0.29) g / 24 h and (1.53 ± 0.21) g / 24 h respectively in control group and 0. 17 g / 24 h in control group , The difference was statistically significant (P <0.05). Conclusions Low-dose urokinase combined with candesartan and candesartan can effectively improve renal function and reduce proteinuria in patients with moderate-severe NS, and the treatment effect is remarkable.