论文部分内容阅读
目的:探讨产妇急进性肾小球肾炎的临床治疗方法及相关影响因素。方法:随机将该院妇产科收治的200例产后急进性肾小球肾炎患者分成治疗组和对照组各100例,治疗组给予血浆置换治疗,对照组给予甲泼尼龙、环磷酰胺、硫唑嘌呤治疗,根据产妇病情程度调节药物剂量。观察两组患者治疗6个月的免疫球蛋白及抗体水平变化情况、24 h尿蛋白定量、尿儿茶酚胺/尿肌酐值、血清尿酸值变化情况及临床治疗的影响因素。结果:两组患者治疗后与治疗前行组内比较IgG、IgA、IgM、髓过氧化物酶-抗中性粒细胞细胞质抗体、抗肾小球基膜抗体、24 h尿蛋白定量、尿Ca/Cr≤0.04例数、血尿肌酸值比较差异均有统计学意义(P<0.05);两组患者治疗后IgG、IgA、IgM、髓过氧化物酶-抗中性粒细胞细胞质抗体、抗肾小球基膜抗体、24 h尿蛋白定量、尿Ca/Cr≤0.04例数、血尿肌酸值进行比较,治疗组各个指标均优于对照组且差异均具有统计学意义(P<0.05);200例患者共治愈162例,对200例患者的临床资料进行分析,结果贫血患者88例、有尿路感染史的患者64例、尿路结石患者27例、体重指数≥24的有102例,分别进行治愈情况与以上因素的相关性分析,结果为治疗效果与贫血、尿路感染史、泌尿系统结石有相关性(P<0.05)。结论:对产妇急进性肾小球肾炎采用血浆置换治疗的效果明显优于常规疗法,并且治疗效果与贫血、尿路感染史、泌尿系统结石有相关性。
Objective: To investigate the clinical treatment of maternal acute glomerulonephritis and related factors. Methods: A total of 200 patients with postpartum acute glomerulonephritis were randomly divided into treatment group (100 cases) and control group (100 cases). Patients in the treatment group were treated with plasma exchange. In the control group, methylprednisolone, cyclophosphamide, Azathioprine treatment, according to the degree of maternal disease regulation of drug doses. The changes of immunoglobulin and antibody levels, 24 h urinary protein, urinary catecholamine / urinary creatinine, serum uric acid level and the influencing factors of clinical treatment in both groups were observed 6 months after treatment. Results: After treatment, the levels of IgG, IgA, IgM, myeloperoxidase-anti-neutrophil cytoplasmic antibody, anti-glomerular basement membrane antibody, 24 h urinary protein, urinary Ca /Cr≤0.04, and there was significant difference in creatine and creatine between two groups (P <0.05). IgG, IgA, IgM, myeloperoxidase-anti-neutrophil cytoplasmic antibody Glomerular basement membrane antibody, 24 h urinary protein, urinary Ca / Cr≤0.04 cases and hematuria and creatine were compared. The indexes in the treatment group were better than those in the control group (all P <0.05) ; 200 cases of a total of 162 cases were cured, the clinical data of 200 patients were analyzed, the results of 88 patients with anemia, a history of urinary tract infection in 64 patients, 27 patients with urolithiasis, body mass index ≥ 24 in 102 cases , Respectively, the correlation between the cure and the above factors, the results for the treatment of anemia, urinary tract infection history, urinary calculi have a correlation (P <0.05). Conclusion: The effect of plasma exchange on maternal acute glomerulonephritis is better than that of conventional therapy. And the therapeutic effect is related to anemia, history of urinary tract infection and urolithiasis.