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中华临床医师杂志(电子版) ›› 2018, Vol. 12 ›› Issue (07) : 394 -399. doi: 10.3877/cma.j.issn.1674-0785.2018.07.005

所属专题: 文献

临床研究

穿心莲内酯对原发肾病综合征并发呼吸道感染患儿的临床疗效观察
张沛1, 夏正坤1,()   
  1. 1. 210002 南京军区南京总医院儿科
  • 收稿日期:2018-01-28 出版日期:2018-04-01
  • 通信作者: 夏正坤

Clinical efficacy of andrographolide in treating children with primary nephrotic syndrome complicated with respiratory infection

Pei Zhang1, Zhengkun Xia1,()   

  1. 1. Department of Pediatrics, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China
  • Received:2018-01-28 Published:2018-04-01
  • Corresponding author: Zhengkun Xia
  • About author:
    Corresponding author: Xia Zhengkun, Email:
引用本文:

张沛, 夏正坤. 穿心莲内酯对原发肾病综合征并发呼吸道感染患儿的临床疗效观察[J/OL]. 中华临床医师杂志(电子版), 2018, 12(07): 394-399.

Pei Zhang, Zhengkun Xia. Clinical efficacy of andrographolide in treating children with primary nephrotic syndrome complicated with respiratory infection[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(07): 394-399.

目的

观察和评价穿心莲内酯治疗原发肾病综合征并发呼吸道感染患儿的临床疗效。

方法

选取南京军区南京总医院2016年3月至2017年3月收治的原发肾病综合征并发呼吸道感染患儿86例,随机分为治疗组和对照组,对照组给予常规抗感染治疗,治疗组在对照组治疗基础上加用喜炎平注射剂。采用χ2检验比较2组患者临床疗效差异,采用t检验比较2组患儿实验室检查各指标,包括白细胞计数、中性粒细胞百分数、淋巴细胞百分数、C反应蛋白、血沉、血液生化、细胞免疫、体液免疫、24 h尿蛋白定量、尿沉渣、肾小管功能等的差异。

结果

治疗组的显效率和治疗总有效率高于对照组(72.09% vs 53.49%;97.67% vs 86.05%),差异具有统计学意义(t=1.964,P=0.026;t=1.832,P=0.048);治疗后,治疗组患儿白细胞计数、淋巴细胞百分比、血沉、24 h尿蛋白定量、尿葡萄糖苷酶和尿视黄醇结合蛋白浓度低于对照组,C反应蛋白浓度、球蛋白的浓度水平高于对照组,差异均具有统计学意义(P<0.05)。治疗组CD3、CD4、CD4/CD8、IgA、IgG、IgM的水平明显高于对照组[(73.18±13.48)% vs (68.29±9.34)%;(30.18±4.52)% vs (27.26±4.27)%;(1.76±0.12) vs (1.37±0.26);(2.17±0.06)g/L vs (1.42±0.19)g/L;(6.31±0.97)g/L vs (5.06±1.17)g/L;(1.94±0.63)g/L vs (1.63±0.49)g/L],差异具有统计学意义[t=1.754,P=0.043;t=1.749,P=0.039;t=2.484,P=0.008;t=2.501,P=0.008;t=1.767,P=0.048;t=1.728,P=0.040]。

结论

穿心莲内酯治疗儿童原发肾病综合征并发呼吸道感染疗效确切,在抗感染治疗的基础上,能改善患儿的细胞免疫和体液免疫学指标。

Objective

To observe the clinical efficacy of andrographolide in treating children with primary nephrotic syndrome complicated with respiratory infection.

Methods

A total of 86 children with primary nephrotic syndrome complicated with respiratory infection treated at our hospital between March 2016 and March 2017 were included and randomly divided into either a control group or a study group. Both groups were given routine anti-infection therapy, and the study group was additionally given Xiyanping injection. The therapeutic effect and laboratory results were compared between the two groups using the t-test and X2 test, respectively.

Results

The rate of significant improvement and the total effective rate in the study group were significantly higher than those in the control group (72.09% vs 53.49%, t=1.964, P=0.026; 97.67% vs 86.05%, t=1.832, P=0.048). After treatment, the leukocyte count, lymphocyte percentage, erythrocyte sedimentation rate, urinary glucosidase concentration, and urinary retinol binding protein concentration in the study group were significantly lower than those in the control group, while the concentrations of C-reactive protein and globulin were significantly higher than those of the control group (P<0.05). The percentages of CD3+ lymphocytes and CD4+ lymphocytes, CD4+ /CD8+ ratio, IgA, IgG, and IgM in the study group were significantly higher than those in the control group [(73.18±13.48)% vs (68.29±9.34)%, t=1.754, P=0.043; (30.18±4.52)% vs (27.26±4.27)%, t=1.749, P=0.039; (1.76±0.12) vs (1.37±0.26), t=2.484, P=0.008; (2.17±0.06) g/L vs (1.42±0.19) g/L, t=2.501, P=0.008; (6.31±0.97) g/L vs (5.06±1.17) g/L, t=1.767, P=0.048; (1.94±0.63) g/L vs (1.63±0.49) g/L, t=1.728, P=0.040].

Conclusion

Andrographolide has a curative effect in treating children with primary nephrotic syndrome complicated with respiratory infection. On the basis of anti-infective therapy, andrographolide can improve the cellular immunity and humoral immunology index.

表1 治疗组和对照组患儿基本资料数据比较
表2 治疗组和对照组患儿感染病原体及病灶分布[例(%)]
表3 治疗组与对照组临床症状改善时间比较(d,±s
表4 治疗组与对照组实验室检查结果数据分析(±s
组别 时间 WBC(×109/L) N(×109/L) L(×109/L) ESR(mm/L) CRP(mg/L) PCT(μmol/L)
治疗组 治疗前 16.42±2.93 6.95±1.44 4.37±1.26 33.11±7.54 31.77±7.36 0.267±0.041
治疗后 8.33±1.87 5.33±1.36 1.86±0.57 10.36±1.55 7.44±2.48 0.048±0.012
对照组 治疗前 16.85±2.61 7.18±1.57 4.62±1.33 34.17±5.08 28.86±6.69 0.238±0.037
治疗后 10.99±2.17 5.17±1.72 2.46±0.92 13.44±2.32 6.19±3.18 0.045±0.043
t ? 2.676 0.625 1.779 1.731 2.789 0.592
P ? 0.006 0.260 0.042 0.038 0.007 0.257
组别 时间 ALB(g/L) CHO(mmol/L) GLB(g/L) ALT(U/L) AST(U/L) Scr(μmol/L)
治疗组 治疗前 36.21±24.07 8.32±1.76 17.47±3.04 18.17±11.21 7.61±2.38 34.76±14.27
治疗后 40.33±26.22 5.37±1.48 20.17±2.65 20.4±13.47 8.37±2.19 35.14±13.36
对照组 治疗前 33.48±27.19 8.18±1.95 17.33±3.86 20.4±12.76 7.72±1.89 35.66±12.71
治疗后 38.77±27.76 5.29±1.98 18.27±3.78 19.85±13.22 8.33±2.64 34.82±11.98
t ? 0.561 0.297 1.781 0.281 0.196 0.251
P ? 0.244 0.373 0.042 0.346 0.546 0.412
组别 时间 BUN(mmol/L) CD3(%) CD4(%) CD8(%) CD4/CD8 IgA(g/L)
治疗组 治疗前 3.92±0.75 39.78±5.37 21.19±5.81 26.38±8.71 0.84±0.02 0.82±0.07
治疗后 3.81±0.63 73.18±13.48 30.18±4.52 27.33±10.37 1.76±0.12 2.17±0.06
对照组 治疗前 3.69±0.93 40.17±6.97 22.61±3.12 27.15±9.93 0.73±0.07 0.79±0.01
治疗后 4.03±1.22 68.29±9.34 27.26±4.27 26.88±10.22 1.37±0.26 1.42±0.19
t ? 0.267 1.754 1.749 0.259 2.484 2.501
P ? 0.389 0.043 0.039 0.390 0.008 0.008
组别 时间 IgG(g/L) IgM(g/L) PRO(mg/kg?24h) 尿沉渣(万) 尿NAG[U/(cg?cr)] 尿RBP(mg/L)
治疗组 治疗前 3.73±1.26 1.39±0.38 128.24±25.77 429.28±1163.38 59.39±11.65 2.39±0.76
治疗后 6.31±0.97 1.94±0.63 42.67±7.55 486.28±387.18 21.62±7.19 0.43±0.04
对照组 治疗前 3.68±0.84 1.43±0.52 132.97±27.38 518.82±418.19 63.11±16.88 2.17±0.48
治疗后 5.06±1.17 1.63±0.49 58.42±19.69 423.76±419.84 28.38±6.51 0.64±0.16
t ? 1.767 1.728 1.944 0.281 2.622 1.769
P ? 0.048 0.040 0.029 0.328 0.007 0.048
表5 治疗组与对照组临床疗效比较[例(%)]
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