The Comparison Of Two Methods For The Treatment Of Children With Nephrotic Syndrome: About132Cases

Objective: To analysize the therapeutic effects on primary nephrotic syndrome inchildren in our hospital.To evaluate the compliance of children in the treatment of thisdisease, and make a foundation to improve the treatment guideline of nephroticsyndrome in children.Methods:132children with PNS enrolled from January1,2008to December31,2008and form January1,2011to December31,2011into this retrospectivelongitudinal study in the pediatric nephrology of the first hospital Bethune jilinuniversity. According to the different guidelines, these children are divided into twogroups: A group and B group. All the children were treated in strict accordance withthe guidelines. Make contrastive study between the two groups on recurrence rate inall the children, less than4years old and over4years old patients. Observe thedifference on the therapeutic effects on refractory nephrotic syndrome and side effectbetween the two groups. Analysize the relationship between urinary protein, albumin(Alb), cholesterol (Chol) and the recurrence rate. Observe the factors in children withrecurrent observation. Analysize the relationship between the treatment ofpathological typing and PNS. At least1years of follow~up for each child. Acomparative evaluation of clinical efficacy and safety of two kinds of treatmentguidelines in the treatment of children with PNS. All of the patients signed writteninformed consent form, ready to participate in this study before treatment.Results:(1) General situation: We conducted the55patients who treatedaccording to the guideline of ‘Clinical classification, diagnosis and treatment ofchildren with glomerular diseases’ during January1,2008to December31as group A,among them: male36cases, female19cases, male. Age from1to14years old, andthe average age (4.49±3.18) years old. The others who treated with the guideline of‘Evidence-based guidelines of the diagnosis and treatment of common childhoodkidney disease’ during January1,2011to December31were conducted into group B, among them: male51cases, female26cases, male. Age from1to15years old, andthe average age (4.58±2.84) years old..(2) The relapse rates of group B are higherthan those of group A, but the difference was not statistically significant (P>0.05).(3)The replapse rates of the patients with the steroid-sensitive nephrotic syndrome(SSNS)who less than4years old are higher than those who over4years old in the group A, inthe group B, in all the children, but the difference was not statistically significant(P>0.05).(4) The rates all side effects of the group B were lower than those of groupA, but the difference was not statistically significant (P>0.05).(5) The relapse factorsof PNS in our research are infection, standardized treatment, no obvious inducedcause. Among them, the infection was the main factor which accounted for60.8%.(6)The increasing urine protein and cholesterol (Chol), and decreasing albumin (Alb) aremore obvious in relapsed group than no relapsed group, but only the difference of theincreasing urine protein was statistically significant (P<0.05).(7) Relationshipbetween clinical classification and relapse: All of the nephritis NS patients wererelapsed, and the possibility of turned to be RNS is high.Conclusion:(1) There is no difference between the two treatment in reducing thePNS relapse rates in children.(2) There is no difference between the two treatment inreducing the PNS relapse rates in the children who is less than4years old.(3) Theicreasing urine protein relates to the relapse rates of the PNS.(4) The infection is themain cause of relapse rates of PNS in children. Prevention of infection is still themain method to decrease the relapse rates of PNS in children.(5) The rate of renalpathological examination in our hospital is low, it needs to be improved.