肾脏病理活检后个体化治疗在肾病综合征患者中临床疗效分析.docVIP

肾脏病理活检后个体化治疗在肾病综合征患者中临床疗效分析 　　DOI：10.16662/j.cnki.1674-0742.2017.25.041 　　[摘要] 目的 探?肾脏病理活检后个体化治疗在肾病综合征诊治中的重要性，为肾病综合征患者临床治愈率提供科学的数据理论依据。 方法 方便选取了该院2014年1月―2017年1月在该科治疗的肾病综合征78例患者为研究对象，年龄为20～75周岁的中老年患者，分为因各种原因未行肾活检的对照组和在该院行肾活检后个体化治疗的观察组，每组39例。对照组均采用中等量泼尼松联合环磷酰胺进行治疗，观察组采用个体化治疗方案，在行肾脏病理活检后根据病理类型分别使用非激素及免疫抑制剂的保守治疗（针对部分膜性肾病且症状较轻及一些继发性肾病综合征的患者）、足量激素、中等量激素联合环磷酰胺、足量激素联合环磷酰胺等方法治疗，观察两组患者的治疗情况、临床指标及不良反应等情况。结果 对照组总有效率为74.36%，观察组总有效率为94.87%，观察组患者不良反应率为5.13%，明显小于对照组，观察组患者生理指标明显好于对照组，差异有统计学意义（P0.05）。 结论肾脏病理活检能够极大的提高肾病综合征患者诊断的准确率，有针对性的个体化治疗方案极大提高治疗效果，具有临床应用意义。 　　[关键词] 肾病综合征；肾脏病理活检；个体化治疗方案；临床疗效分析 　　[中图分类号] R692.3 [文献标识码] A [文章编号] 1674-0742（2017）09（a）-0041-03 　　Clinical Analysis of Individualized Treatment after Renal Biopsy in Patients with Nephrotic Syndrome 　　ZHENG Peng-fei 　　Department of Nephrology， Changchun Central Hospital， Changchun， Jilin Province， 130051 China 　　[Abstract] Objective This paper tries to investigate the importance of individualized treatment of renal biopsy in the diagnosis and treatment of nephrotic syndrome， and to provide scientific data for the clinical cure rate of nephrotic syndrome patients. Methods 78 cases of nephrotic syndrome patients treated in this hospital from January 2014 to January 2017 were conveniently selected as the research objects， whose age were between 20 ～ 75 years old， and were divided into the observation group and the control group with 39 patients in each group. The control group did not undergo renal biopsy in this hospital for various reasons with moderate amounts of prednisone and cyclophosphamide treatment， and the observation group underwent renal biopsy and implemented individualized treatment. After the treatment of kidney biopsy， the observation group was treated with conservative treatment of non hormone and immunosuppressant according to the pathological type （for membranous nephropathy and mild symptoms and some secondary nephrotic syndrome patients）， sufficient hormone treatment and medium amount of hormone a