|
|
|
| Enhancement Effects of Plasma Exchange Combined with Adrenal Cortical Hormone on Rapidly Progressive Glomerulonephritis |
| ZUO Wei, SONG Bo-yi, CAO Li,et al |
| Department of Nephrology, the 463th Hospital of Chinese PLA, Liaoning, Shenyang 110042 |
|
|
|
Abstract 【Objective】To explore the clinical efficacy of intensive plasma exchange and glucocorticoid therapy on rapidly progressive glomerulonephritis. 【Methods】 Fifty-nine patients with rapidly progressive glomerulonephritis (RPGN) were analyzed retrospectively. All patients were treated with combined with adrenocortical hormone therapy. The patient's outcomes were analyzed.【Results】Patients accepted intensive plasma exchange treatment with an average of 13.2±2.6 times, had an average hospital length of 72.8±11 days , average hematuria disappearance procedure of 27.4±11.6 days, mean edema subsided time of 15.8±5.1 days, and blood pressure recovery of 14.7±4.2 days. After 4 weeks and 8 weeks of treatment, there were evidence the showed improvement of ALB, eGFR, and 24h urine volume with statistical significances (P<0.05). On the other hand, urine protein, serum creatinine (SCR), anti GBM (anti-glomerular basement membrane) antibody value were reduced significantly after treatment, the difference were also statistically significant (P<0.05). Of those 59 patients, 15 (25.42%) were cured, 34 improved (57.63%), and 10 were invalidated (16.95%). The 10 invalid patients after discharge were treated with long-term hemodialysis in our outpatient hemodialysis center. 【Conclusion】Intensive plasma exchange combined with adrenal cortical hormone treatment is valuable for rapidly progressive glomerulonephritis.
|
|
Received: 31 May 2016
|
|
|
|
|
|
[1] 吴刚,陈文,邓存良,等.小剂量血浆置换序贯血浆灌流对慢加急性肝衰竭患者疗效观察[J].重庆医学,2014,43(25):3281-3283.
[2] Sugawara K Nakayama N,Mochicla S.Acute liver failure in Japan:definition,classification,and prediction of the outcome[J].J Gastroenterol,2012,47(8):849-861.
[3] 梁佐堂,李继峰.脑后部可逆性脑病综合征临床特征及MRI表现[J].现代仪器与医疗,2015,21(1):12-14.
[4] 曾玲玲,胡章学.ANCA相关性小血管炎诱导缓解治疗进展[J].中国中西医结合肾病杂志,2015,16(1):85-87.
[5] 白培进,张勇,李俊霞,等.激素冲击和联合血浆置换治疗ANCA相关性血管炎的疗效比较[J].中华肾脏病杂志,2015,31(2):97-101.
[6] 刘睿.糖尿病肾脏疾病合并膜性肾病一例[J].临床肾脏病杂志,2013,13(4):191-192.
[7] 鲍帆,潘长虹,孙莉.抗中性粒细胞胞浆抗体在肾脏疾病中的诊断价值[J].国际检验医学杂志,2014,35(3):345-346.
[8] 吴歌,权松霞,张茜,等.紫癜性肾炎的临床病理及治疗方法分析[J].中日友好医院学报,2013,27(6):338-340.
[9] 王勇,蒋瑾,钟智,等.抗中性粒细胞胞质抗体相关性血管炎肺部影像学的表现与诊断意义[J].实用医院临床杂志,2014,11(3):214-217.
[10] Huang P,He Z,Ji S,et al.Induction of functional hepatoeyte-like cells from Mouse fibroblasts by defined factors[J].Nature,201l,475(7356):386-389.
|
|
|
|
2017, Vol. 34 
