摘要
目的探究低分子右旋糖酐联合呋塞米治疗小儿肾病综合征的临床疗效。方法选取2015年4月至2017年4月新疆维吾尔自治区人民医院收治的70例小儿肾病综合征为研究对象,依据治疗方法不同分为对照组和观察组,每组35例。两组均给予常规的抗感染、利尿消肿、维持酸碱平衡、抗凝等治疗,对照组给予呋塞米治疗,静脉滴注,起始按体重2 mg/kg,必要时每4~6小时追加1~2 mg/kg,最大剂量可达每日6 mg/kg;观察组给予低分子右旋糖酐联合呋塞米治疗,在对照组的基础上每次给予患儿5~10 m L/kg的低分子右旋糖酐静脉滴注。两组均连续治疗4周。比较两组患儿的临床疗效、肾功能指标的变化。结果观察组临床总有效率显著高于对照组[88.57%(31/35)比74.29%(26/35)](P<0.05)。治疗后,观察组血清肌酐、血尿素氮、血清胱抑素C以及尿β2微球蛋白、尿微量白蛋白均低于对照组[(106.23±14.90)mmol/L比(120.78±15.46)mmol/L、(4.89±1.29)mmol/L比(5.51±1.30)mmol/L、(0.45±0.04)mg/L比(0.71±0.41)mg/L、(0.12±0.01)mg/L比(0.23±0.11)mg/L、(10.24±2.01)mg/L比(14.42±3.74)mg/L](P<0.01),血清肌酐清除率高于对照组[(62.09±5.11)m L/min比(58.31±4.90)m L/min](P<0.01)。结论低分子右旋糖酐联合呋塞米治疗小儿肾病综合征临床疗效显著,能有效改善其肾功能指标,为患儿预后提供保障。
Objective To explore the clinical effect of low molecular dextran combined with fm＇osemide on nephrotic syndrome in children. Methods A total of 70 children with nephrotic syndrome tread in Children＇s Hospital of Xinjiang Uygur Autonomous Region from Apr. 2015 to Apr. 2017 were included in the study, and divided into a control group and an observation group according to the treatment method, 35 cases in each group. Both groups were treated with conventional anti-infection, diuretic detumescence, maintaining the balance of acid and alkali, and anticoagulation. The control group was treated with furosemide, intravenous drip, starting with 2 mg/kg by body weight, added with 1-2 mg/kg every 4-6 hours, up to 6 mg/kg per day if necessary; the observation group was given low-molecular dextran（5-10 mL/kg） by intravenous drip on the basis of the control group＇s regimen. Both groups were treated for 4 weeks continuously. The clinical curative effect,changes of blood lipid,and renal function indexes of the two groups were compared. Results The total clinical effective rate in the observation group was higher than that in the control group [ 88.57% （31/35） vs 74.29% （26/35）1 （P 〈 0.05 ）. After treatment, the levels of sermn creatinine, blood urea nitrogen, sermn cystatin C and urine [32 microglobulin and microalbuminuria in the observation group were lower than those in the control group [ （ 106.23 ± 14.90 ） mmol/L vs （120.78 ±15.46） mmol/L, （4. 89±1.29） mmol/L vs （5.51 ±1.30） mmol/L,（0.45 ±0.04） mg/L vs （0.71 ±0.41） ng/L,（0.12±0.01） mg/L vs （0.23±0.11） mg/L,（10. 24±2.01） mg/Lvs （14.42±3.74） mg/Ll（P〈0. 01）,serum ereatinine clearance rate was higher than that in the control group[ （62.09 ± 5.11 ） nil/rain vs （58.31 ±4.90） mL/minJ （P 〈0.01 ）. Conclusion The use of low molecular dextran combined with furosemide in the treatment of pediatric nephrotic syndrome can effectively improve the renal function index, providing guarantee for the prognosis of the children.
作者
拜尔娜.那扎瓦尔
白玲
林磊
BAIERNA · Nazhawaer;BAI Ling;LIN Lei(Department of Pediatrics,Children＇s Hospital of Xinjiang U-ygur Autonomous Region,Urumqi 830001,China)
出处
《医学综述》
2018年第19期3946-3949,3953,共5页
Medical Recapitulate
基金
新疆维吾尔自治区人民医院科技引进创新项目(20170109)
关键词
小儿肾病综合征
低分子右旋糖酐
呋塞米
肾功能
Nephrotie syndrome in children
Low molecular dextran
Furosemide
Renal function
