大剂量甲基强的松龙及环磷酰胺联合冲击治疗狼疮性肾炎合并急性肾衰竭的疗效观察

摘要

Objective:To explore the clinical effect of large dose of Methylprednisolone and Cyclophosphamide combined with shock therapy in the treatment of lupus nephritis complicated with acute renal failure.Method:32 patients with lupus nephritis complicated with acute renal failure admitted to our hospital from January 2014 to January 2015 were selected as research objects,and they were randomly divided into the experimental group and the control group, 16 cases in each group.The experimental group was given large dose of Methylprednisolone and Cyclophosphamide method combined with shock therapy,the control group was given Cyclophosphamide plus standard hormone therapy for treatment.The therapeutic effect,the time of urine protein decreased by 50%,disappearance of hematuria and blood creatinine recovery between the two groups were compared and analyzed.Result:After treatment,the time of urine protein decreased by 50%,disappearance of hematuria and blood creatinine recovery in the experimental group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of the experimental group was significantly 93.75%,which was significantly higher than 56.25%of the control group,the difference was statistically significant( χ2=4.1667,P=0.0412).Conclusion:Large dose of Methylprednisolone and Cyclophosphamide combined with shock therapy in the treatment of lupus nephritis complicated with acute renal failure, can obviously improve the therapeutic effect,effectively improve the symptoms of urinary protein and hematuria,drug safety,is worthy of clinical promotion.%目的：探究大剂量甲基强的松龙以及环磷酰胺联合冲击治疗狼疮性肾炎合并急性肾衰的临床效果。方法：选取2014年1月-2015年1月本院收治的32例狼疮性肾炎合并急性肾衰竭患者作为研究对象，将其随机分为试验组和对照组，每组16例。试验组采用大剂量的甲基强的龙松及环磷酰胺联合冲击治疗，对照组采用环磷酰胺加标准激素的治疗方法进行治疗。对两组患者的治疗效果、尿蛋白减少50%时间、血尿消失时间及血肌酐恢复时间进行比较分析。结果：经治疗后，试验组的尿蛋白减少50%时间、血尿消失时间及血肌酐恢复时间均明显短于对照组，差异均有统计学意义（P<0.05）。试验组的治疗总有效率93.75%明显高于对照组的56.25%，差异有统计学意义（χ2=4.1667，P=0.0412）。结论：对狼疮肾炎结合急性肾衰竭的患者采用大剂量的甲基强的松龙和环磷酰胺联合冲击治疗，可明显提高治疗效果，有效改善尿蛋白、血尿等症状，用药安全性高，值得临床推广。