Oral Enough Prednisone Effects On Children Of Nephrotic Syndrome With Peripheral Hemogram And Vital Signs

Objective: Nephrotic syndrome(NS)is a kind of the glomerular filtration membrane of plasma protein increased permeability,lost of plasma protein from urine,and cause a series of pathophysiological changes of a clinical syndrome.It can present a variety of types of pathological changes.Among them,small lesions,membranous nephropathy,focal segmental type and mesangial proliferation types are relatively rare.In recent years,the incidence of the disease has a rising trend year by year,which seriously affects life quality of children and their families.In children hospitalized for urinary system disease,second only to intrinsic acute nephritis,is a common disease of urinary infantile period,and the repeated illnesses out the more seriously influence children's health and quality of life.As the main clinical application of the disease,corticosteroids plays an indispensable role.Children with nephrotic syndrome due to the lost large amounts of protein in urine,repeatedly used glucocorticoid,resulting in a decline in immune function and tends to get infected,and onset is relatively hidden,if cannot be found early,easy cause serious complications,and even life-threatening,so early detection,early diagnosis,early treatment is particularly important.Concurrent infection,and the application of glucocorticoid for children with kidney disease have effects on peripheral blood like and vital signs,but not easy to distinguish.This study on oral enough prednisone treatment of children with nephrotic syndrome with peripheral vision and vital signs of follow-up and data collection,dynamic study of glucocorticoid for the children the influence degree of the vital signs and routine blood,and cause the adverse reactions such as infection,hypertension,the early performance of phase identification,in order to do it in the process of disease treatment,prevent the occurrence ofadverse reactions.Methods:1 The objectives of studyThis study adopts a prospective study method to choose 30 children who were initially diagnosed as nephrotic syndrome in the outpatient section of Xing Tai People's Hospital from December 2014 to December 2015,who has taken prednisone in 4 weeks or more.Nephrotic syndrome is diagnosed on the basis of the seventh edition of the practical pediatrics by Zhu Futang:(1)a large amount of proteinuria,qualitative check(+ + +),or quantitative daily for more than 50 mg/kg;(2)low serum albumin leels: serum albumin < 30 g/L;(3)hypercholesterolemia(hyperlipidemia),serum cholesterol over 5.72 tendency for L(220 mg/dl);(4)children with renal abnormalities,causing renal vascular malformation and damage due to the original kidney disease;(5)children with basic diseases of heart,liver,lung and brain.2 Research methodsWill be included in the serial number pre-operation,followed up for 4weeks,exclude external factors,such as infection,collect each period(0,1week,2 weeks,3 weeks,4 weeks)blood picture and temperature data,is divided into five groups: group A: namely into the group and has not yet been used glucocorticoid measurement data before;Group B: apply enough prednisone at 1 week of the test data;Group C: apply enough prednisone 2weeks when the test data;Group D: apply enough prednisone for three weeks when the test data;Group E: apply enough prednisone 4 weeks when the test data.Adopt the method of its control and parallel control,look for oral prednisone on full amount into the group of children with blood picture and the influence of vital signs,data statistical description and analysis of the above.3 Test method3.1 Extraction of venous blood routine blood testprofessional inspectors take intravenous blood and send to the laboratory of the People's Hospital in Xingtai City for routine blood tests.The researchuses the method of resistance type of blood cell,takes advantage of blood cell suspended in the electrolyte solution through holes causing resistance change as a test,transfers the number of pulses into a number of cells after amplification and screening of the corresponding pulse signal.The pulse height is proportional to the cell size.Methods: extraction of venous blood in children with 1 ml,injection of anticoagulant tube,gently shaking,make the blood and anticoagulant fully blending,blood in a state of anticoagulation.In a routine blood test machine,print report in a timely manner.3.2 Measurement of vital signspersonnel apply electronic thermometer to the forehead of childreniin a quiet condition in a morning,3 measurements are averaged and making a record.4 Statistical analysisApplication of SPSS17.0 to the experimental data and making a description and analysis.Measurement data is represented as standard deviation,many comparison using single factor analysis of variance,two comparison using the LSD-t test.P<0.05 for the difference is statistically significant.Results :1 Temperature changes: elevated body temperature,there are 29 people,accounting for 96.7%,including 1 in weekend rose ten people,accounting for33.3%,2 weekend up 15 people,accounting for 50%,3 weekend rose four people,accounting for 13.3%(Fig.1);Measuring temperature of 37 ? ~37.5 ? between 20 people,accounting for 66.7%,more than 37.5 ?,nine people accounted for 30%,up to 37.9 ?.A group of average temperature of36.3±0.3 ?,the average temperature is 37.4±0.5 ? group B;The average temperature of 37.6±0.2 ? group C;Group D average temperature of 37.9±0.1 ?;The average temperature of 37.8 ± 0.2 ? group E;Oral prednisone acetate full amount of all the children of the basal body temperature increase was statistically significant(P<0.05).2 Increased total number of white blood cells in laboratory tests has 26 people,accounting for 86.7%,rose has 21 people,including 1 in weekend(70%),2 weekend up two people,accounting for 6.7%,3 weekend up two people,accounting for 6.7%,4 one weekend rise,accounted for 3.3%;The total number of white blood cells 10 ~ 15 x 109 / L 15 people,accounting for50% and > 15 x 109 / L 11,accounted for 36.7%,up to 21.6 x 109 / L(figure2);A group of white blood cell average of 7.82±1.28 x 109 / L,B group of white blood cell average of 12.68±0.96 x 109 / L;White blood cells of group C mean value of 14.0±1.02 x 109 / L;Group D leucocyte averages of 13.99±1.14 x 109 / L;Group E leucocyte averages of 13.59±1.37 x 109 / L;Children with oral prednisone acetate tablets in peripheral blood leucocyte heighten of statistical significance(P<0.05).3 Increased platelet total 23 people,accounting for 76.7%,including 1 in weekend rose has 16 people,accounting for 53.3%,2 weekend up five people,accounting for 16.7%,3 weekend up two people,accounting for 6.7%(Fig.3);Platelet total of 300 ~ 500 x 500 / L 15 people,accounting for 50%and > 500 x 109 / L have 8 people,accounting for 26.7%,up to 893 x 109 /L.Platelet average of 135±13 x 109 / L group A,group B average of 324±15x 109 / L,platelet platelet group C average of 376±14 x 109 / L,group D average of 394±16 x 109 / L,platelet platelet group E average of 415±17 x109 / L;Oral prednisone acetate full amount of the increased peripheral blood platelets as children was statistically significant(P<0.05).Conclusions: Oral enough prednisone acetate for nephrotic syndrome in children with peripheral blood leukocytes,platelets and basal body temperature in elephant all have certain influence,temperature fluctuations exists obvious individual differences,but most of them have rise,but not more than 38 ?;Interleukin increased amplitude is larger,2 weeks before 4 weeks part will fall;Increased platelet persistent,peaked at 4 weeks.