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国际医药卫生导报 2016年 第 22卷 第 22期 IMHGN，November 2016，Vo1．22 No．22 随访对肾病综合征患者依从激素联合免疫 抑制剂治疗的影响 张平 刘彩梅 潘丽珠 510120 广州，广州医科大学附属第一医院肾内科 通信作者：张平 ，E-mail：511417714@qq．com DOI：10．3760／cma． j．issn．1007-1245．2016．22． 050 【摘要 】 目的 探讨随访对原发性肾病综合征依从激素联合免疫抑制剂 (CTX)治疗的影响。方法 选取 2011年 2月至 2015年 7月于本院行激素联合 CTX治疗的原发性肾病综合征患者 36例 ，对其进行 电话随访 ，观察患者是否定期回医院治疗、是否出现并发症、出现并发症是否立即回院治疗，总计 9次。 结果 36例患者 9次回院治疗的百分率依次为 100．0％、97．2％、91．7％、88．9％、86．1％、86．1％、88．1％、 86．1％、86．1％。第 1～9次回访患者大量蛋白尿控制人数逐渐下降，血白蛋白正常值人数增加；血胆固 醇正常值人数第 1次与第 6～9次回访比较，差异有统计学意义 (P<0．01)。甘油三脂正常值人数第 1 次与第 9次回访比较，白细胞计数第 1次至第 6次回访比较 ，差异有统计学意义 (P<0．05)；个别患者 出现谷丙转氨酶上升。结论 糖皮质激素联合 CTX治疗原发性肾病综合征患者，有延续护理的需求。护 士通过电话随访，患者得到心理疏导 ，积极配合治疗方案，并能及时发现并发症，将并发症的严重程度降低 ， 从而提高疗效，促进康复。 【关键词 】 随访 ；原发性肾病综合征；糖皮质激素；免疫抑制剂 Effect of follow-up on treatment compliance in patients with nephrotic syndrome treated by glIucocorf icoid and immunosuppressant Zhang Ping,Liu Caime~Pan Lizhu DepartmentofNephrology,FirstHospital GuangzhouMedicalUniversity,Guangzhou 510124 China Corresponding author：Zhang Ping,E-mail：51141 7714@gg．cor n 【Abstract】 objective To explore the ef fect of follow—up on treatment compliance in patients with nephrotic syndrome treated by glucocorticoid and immunosuppressant(CTX)．Methods 36 patients with primary nephrotic syndrome treated with glucocorticoid and CTX at our hospital from February,201 1 to July, 20 1 5 were selected and were followed up by telephone 9 times；whether the patients regularly went back hospital for treatment，whet her mey got complications,a n d whether they immediately came back when occurring complications were observed．Results The back—for-treatment percentages of t he 9 follow-ups of t he 36 patients were 100．0％，97．2％，91．7％，88． 9％，86．1％，86．1％，88．1％，86．1％ and 86．1％，respectively．The 9 follow-ups showed that more and more patients got albuminuria a n d nor m al blood albumin．The number of patients with normal blood cholesterol oft he f irst f ollow．up was statistically di ferent f rom that oft hose ofthe 6th to 9th f ollow． ups(P<0． 0 1)．T h e number of patients with normal blood triglyceride of the f irst follow—up was statistically dif ferent f rom that of the 9th follow-up (P<0．05)．The count of WBC of t he f irst follow-up was statistically dif ferent f rom that of the 6th follow—up(P<0．05)．Few patients’alanine aminotransferase level increased． Conclusions Patients with primary nephrotic synd rome treated by glucocorticoid a nd CTX have the need for continuous nu rsing care．Through telephone follow—up by nu rses，the patients receive psychological counseling a n d actively COoperate with t he treatment，a nd complications Ca n be found out in time，a n d severe complications reduced，a n d the cu rative effect improved，a nd the rehabilitation promoted． 【Key words】 Follow—up；Pr imary neph rotic synd rome；Glucocorticoid；Immunosuppressa nt 原发性肾病综合征是肾内科常见的慢性疾。 临床上首选糖皮质激素联合免疫抑制剂 (CTX)治 疗，疗效较好，复发率较低 n_ ；但是疗程长，很多 患者 自行停用糖皮质激素，或者未按时回医院输注 3522 CTX，或者出现感染、肝功能异常未能及时诊治等， 从而耽误病情影响疗效。为了使这些患者得到行之 有效的治疗及护理，本研究对原发性肾病综合征患 者进行激素联合 CTX治疗期间，护士定期针对性进