Objective To observe the effect of Glucocorticoid on primary nephrotic syndrome ( PNS ) combined with tuberculous pleurisy. Methods Eleven patients with PNS accompanied by tuberculous pleurisy were administered prednisone, benazepril hydrochloride, calcium, anti - platelet aggregation. After 8 weeks given alternate day therapy of glucocorticoid and meanwhile standard anti - TB chemotherapy. 24 h urinary protein excretion, plasma albumin, edema, and temperature, eryth-rocyte sedimentation, chest X - ray, ultrasonic B and other indexes were observed after 4 weeks and 8 weeks of treatment. Results After 8 weeks, complete remission of PNS symptom was noted in 7 patients, partial in 3 , no remission in 1. Tuberculous pleurisy symptoms fully recovered or partially in all patients. Edema gradually disappeared, body temperature returned to normal, poisoning eased, chest X - ray and ultrasound showed disappearance of pleural effusion, 24 h urinary protein excretion gradually reduced, plasma albumin level elevated, erythrocyte sedimentation returned to normal. Conclusion Glucocorticoid, having remarkable effects on PNS combined with tuberculous pleurisy, is safe and effective.%目的 观察糖皮质激素治疗原发性肾病综合征(PNS)合并结核性胸膜炎的疗效.方法 我院2007年12月-2011年12月收治的11例PNS合并结核性胸膜炎患者,给予泼尼松、盐酸贝那普利、补钙、抗血小板聚集等治疗8周,8周后糖皮质激素改为隔日疗法;同时给予标准抗结核化疗方案治疗.观察治疗4周、8周后24 h尿蛋白定量、血浆清蛋白、水肿变化情况及体温、血沉、胸部X线、B超等指标变化.结果 治疗8周后,7例患者PNS症状完全缓解,3例部分缓解,1例未缓解;结核性胸膜炎症状均完全好转或部分好转,无未好转者.患者水肿逐渐消失,体温恢复正常,结核中毒症状缓解,胸部X线及B超显示胸腔积液消失,24 h尿蛋白定量逐渐减少,血浆清蛋白水平升高,血沉逐渐恢复正常.结论 糖皮质激素治疗PNS合并结核性胸膜炎效果明显,配合标准抗结核化疗方案,对结核性胸膜炎结核中毒症状的改善有协同作用,提高了临床疗效.
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