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研究目的肾上腺皮质激素是诱导肾病综合征(PNS)缓解的首选药物,但因需大剂量,长疗程,可发生不同程度的合并症。本研究旨在比较不同激素治疗方法,筛选出疗效好、副作用少的给药方法。研究方法 122例PNS患儿随机分为3组,分别按qd、qod和分次疗法施以激素后,劝态观察临床症状、尿蛋白和血液生化检测及副作用等指标,统计学处理采用卡方检验。研究结果qd、qod、分次疗法组有效率分别为97.62％、97.5％、97.5％,三组近期疗效比较无显著性差异(P>0.05);水肿消退时间及尿蛋白消失时间qod组(分别为17.57±11.1天,46.14±17.8天)较qd组(10.08±7.0天,21.89±15.49天)和分次疗法组(11.47±14.68天,21.62±16.32天)长(P<0.05),后两组比较无显著性差异(P>0.05)。3组疗法激素副作用比较有显著性差异(P<0.01),分次疗法组发生率最高,qd组较低,qod组最低。结论对小儿PNS首始治疗应采用每日凌晨顿服法。
Research purposesAdrenal cortex hormones is the drug of choice to induce nephrotic syndrome (PNS) remission, but due to high doses, long course of treatment, can occur in varying degrees of complications. This study aims to compare different hormone treatment methods, screening out the good effect, less side effects of drug delivery methods. Methods 122 cases of PNS children were randomly divided into three groups, respectively, after qd, qod and divided therapy were given hormones, persuasion observed clinical symptoms, urinary protein and blood biochemical tests and side effects and other indicators of statistical analysis using chi square test. The results showed that the effective rates of qd, qod and divided therapy group were 97.62%, 97.5% and 97.5% respectively, there was no significant difference between the three groups in short term efficacy (P> 0.05); edema subsided time and proteinuria disappear time qod group (17.57 ± 11.1 days, 46.14 ± 17.8 days) than the qd group (10.08 ± 7.0 days, 21.89 ± 15.49 days) and the divided therapy group (11.47 ± 14.68 days, 21.62 ± 16.32 days) There was no significant difference between the two groups (P> 0.05). There were significant differences between the three groups in the side effects of hormone therapy (P <0.01), the highest incidence rate in the divided therapy group, qd group was lower, qod group was the lowest. Conclusion The first treatment of pediatric PNS should be daily morning service method.