Abstract:
Objective
To observe the curative effect of dexamethasone combined with gamma globulin in treatment of children with Henoch Schonlein purpura nephritis and its effect on urinary protein and urine red blood cells.
Methods
A total of 90 cases of allergic purpura treated in our hospital were randomly divided into observation group and control group, 45 cases in each group. The control group was given dexamethasone treatment，and observation group were treated with dexamethasone combined with gamma globulin, four weeks as a course. The clinical efficacy, blood coagulation index before and after treatment, 24h urine protein and urine red cell level and adverse reaction were observed.
Results
The total effective rate of observation group after treatment was 95.6%(43/45), significantly higher than the control group(77.8%,35/45),the difference being statistical(P<0.05). After 4 weeks of treatment, PT value of both groups had no significant change(P>0.05). APTT was significantly higher in the observation group than in the control group after treatment, while FIB was significantly lower, the difference being statistical(P<0.05). After treatment, the level of 24h urine protein and urine red blood cells was lower than before treatment, and the difference was statistical (P<0.05); the level of 24h urine protein and urine red blood cells of observation group was significantly lower than that in control group, the difference being statistical(P<0.05).The occurrence rate of adverse reaction was 4.4%(2/45) in observation group, and 6.7%(3/45) in control group, there being no difference between the two groups(P>0.05). There was no statistical difference in the occurrence rate of renal damage between the two groups before and 4 weeks after treatment(P>0.05). The follow-up after 3 months of treatment revealed that the rate of renal damage in control group was 28.9%(13/45), significantly higher than that in observation group(11.4%,5/44),in which group one case was lost of follow-up, and the difference was statistical(P<0.05).
Conclusion
The treatment with dexamethasone combined with gamma globulin has good effect on children with Henoch Schonlein purpura nephritis,which can significantly decrease the level of urine protein and red blood cells and improve the renal function; it has fewer adverse reactions and is worthy of clinical application.

Key words: Henoch Schonlein purpura nephritis, Dexamethasone, Gamma globulin, Urine protein, Urine red blood cell, Child