Department of Pediatrics, First Affiliated Hospital of Anhui Medical University, No.218 Ji-Xi Road, Hefei 230022, Anhui, China.
Indian J Pediatr. 2012 Feb;79(2):207-12. doi: 10.1007/s12098-011-0519-5. Epub 2011 Jul 8.
To evaluate the different therapies used to treat mild, moderate and severe Henoch-Schonlein purpura nephritis (HSPN) patients and to identify the most effective treatment.
One hundred and eighty six children were evaluated retrospectively. They were divided into mild, moderate and severe condition groups. Different therapeutic protocols of non-steroid therapy, hydrocortisone sodium succinate (HCSS) therapy, methylprednisolone (MP) pulse therapy, and MP in combination with tripterygium glycoside (TG) therapy were used to treat the different groups.
After 4 wk, in the mild group, patients were more likely to respond to HCSS therapy than non-steroid therapy (P < 0.05). Moderate HSPN patients were more likely to respond to MP therapy than HCSS therapy (P < 0.05). Severe HSPN patients were more likely to respond to MP in combination with TG than single MP therapy (P < 0.05). At last follow-up, all children had normal urinalysis, blood pressure and serum urea and creatinine. In the mild group, the mean duration of proteinuria was shorter in HCSS therapy group than in non-steroid therapy group (P < 0.05). In the moderate group, the mean duration of proteinuria was shorter in MP pulse therapy group than in HCSS therapy group (P < 0.05).
The present study has demonstrated a superior effect of HCSS therapy in patients with mild HSPN disease, of MP therapy in patients with moderate disease, and of MP in combination with TG therapy in patients with severe disease. Intensive therapy administered initially reduces the duration of urinary protein abnormality.
评估治疗轻、中、重度过敏性紫癜肾炎（HSPN）患者的不同疗法，并确定最有效的治疗方法。
回顾性评估了 186 例儿童。他们被分为轻度、中度和重度组。不同的治疗方案包括非甾体治疗、琥珀酸氢化可的松（HCSS）治疗、甲基强的松龙（MP）脉冲治疗以及 MP 联合雷公藤多苷（TG）治疗，用于治疗不同组的患者。
4 周后，在轻度组中，HCSS 治疗比非甾体治疗更可能使患者产生反应（P<0.05）。中度 HSPN 患者对 MP 治疗的反应比 HCSS 治疗更可能（P<0.05）。重度 HSPN 患者对 MP 联合 TG 治疗比单独 MP 治疗更可能产生反应（P<0.05）。最后一次随访时，所有儿童的尿液分析、血压和血清尿素氮及肌酐均正常。在轻度组中，HCSS 治疗组蛋白尿的平均持续时间短于非甾体治疗组（P<0.05）。在中度组中，MP 脉冲治疗组蛋白尿的平均持续时间短于 HCSS 治疗组（P<0.05）。
本研究表明，HCSS 治疗对轻度 HSPN 患者、MP 治疗对中度患者、MP 联合 TG 治疗对重度患者均有较好的疗效。初始强化治疗可缩短尿蛋白异常的持续时间。
