地塞米松冲击疗法对肾病综合征患者脂联素和内皮素水平影响.docVIP

地塞米松冲击疗法对肾病综合征患者脂联素和内皮素水平影响 　　[摘要] 目的 观察地塞米松冲击疗法对肾病综合征患者脂联素和内皮素水平的影响及其疗效。方法 观察组58例,给予地塞米松1～2mg/(kg?d)(最大剂量50mg/d)加入5%～10%的葡萄糖100～200mL中静滴,0.5～1h内完成,1次/d,连用3d,后改为地塞米松1～2mg/(kg?d)静滴,隔天1次,共3次,冲击治疗完成后48h改口服泼尼松1.5～2mg/(kg?d)(最大剂量60mg/d),以替代中长程疗法诱导缓解阶段。巩固和维持治疗阶段仍按中长程疗法实施。对照组49例,按标准中长程疗法口服泼尼松进行治疗,开始剂量同观察组。测定治疗前后血清脂联素和血浆内皮素。结果 治疗后的观察组患者脂联素和内皮素水平低于同期对照组(P0.05),2周转阴率显著高于对照组(P0.05)。结论 地塞米松可以快速有效地降低肾病综合征患者的脂联素和内皮素水平。 　　[关键词] 地塞米松;肾病综合征; 脂联素;内皮素 　　[中图分类号] R692 [中图分类号] A[文章编号] 1673-9701(2009)24-13-03 　　 　　Effect of Dexamethasone Pulse Therapy on Adiponectin and Endothelin in Nephrotic Syndrome 　　HUANGGuozhen 　　Dayi County Peoples Hospital,Sichuan 611330,China 　　 　　[Abstract] Objective To investigate the effect of dexamethasone pulse therapy on adiponectin and endothelin in nephrotic syndrome (NS). Methods The observation group(58 patients with NS) were given the treatment of intravenous drip of 1～2mg/(kg?d) of dexamethasone(maximum dose 50mg/d) added in 100~200mL of dextrose at a concentration of 5%～10%,which was required to be completed within 0.5～1h(once/d) for 3 consecutive days; then the observation group was changed to be given the treatment of intravenous drip of dexamethasone 1～2 mg/(kg?d), once every two days,three times in total; 48 hours after the pulse therapy,oral prednisolone 1.5～2mg/(kg?d)(maximum dose 60mg/d) was used as the replacement treatment of long-and medium-term therapy remission induction phrase. In consolidation and maintenance, the long-and medium-term therapy was applied. The control group(49 patients with NS) was treated with oral prednisolone as the standard long- and medium-term therapy with the initial dose as much as that used for the observation group. Serum adiponectin and plasma endothelin were measured. Results After dexamethasone pulse therapy,serum adiponectin and plasma endothelin were lower than those before treatment(P0.05); the negative conversion rate of urine protein in 2 weeks in the observation group was higher than that in