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编号:10972183
环磷酰胺治疗儿童肾病综合征型紫癜性肾炎体会
http://www.100md.com 《疑难病杂志》 2006年第2期
肾病综合征,,肾病综合征;紫癜性肾炎;环磷酰胺;儿童,1资料与方法,2结果,3讨论,参考文献
     【摘要】 目的 探讨环磷酰胺(CTX)治疗儿童肾病综合征型紫癜性肾炎的疗效。方法 48例肾病综合征型紫癜性肾炎随机分为治疗组(n=25)与对照组(n=23),治疗组给予泼尼松1.5~2.0 mg·kg-1·d-1口服,双嘧达莫1~2 g·kg-1·d-1口服,并用CTX 8~10 mg·kg-1·d-1,加入生理盐水100 ml中静滴,2 d为1个疗程,每4周给予1个疗程,总累积量<150 mg/kg;对照组用泼尼松1.5~2.0 mg·kg-1·d-1口服,双嘧达莫1~2 g·kg-1·d-1口服。4个疗程后观察比较2组疗效。结果 治疗组总有效率为96.0%,疗效优于对照组的82.6%(P<0.05)。2组治疗前后24小时尿蛋白定量、血清白蛋白、总胆固醇、甘油三酯均有显著差异(P<0.05或P<0.01),且治疗组明显优越于对照组(P<0.01),无明显不良反应。结论 采用小剂量、长间隔CTX治疗儿童肾病综合征型紫癜性肾炎疗效好,不良反应少。

    【关键词】 肾病综合征;紫癜性肾炎;环磷酰胺;儿童

    Therapeutic effect of cyclophosphamide on nephrotic syndrome purpuric nephritis in children

    DAI Xianguo,ZHONG Wenqi,LIU Zhihua.

    Department of Pediatrics, The First Clinical Hospital of Three Gorges University ,Hubei,Yichang 443003,China

    【Abstract】 Objective To investigate the therapeutic effect of cyclophosphamide (CTX) on nephrotic syndrome purpuric nephritis in children.Methods 48 children patients with nephrotic syndrome purpuric nephritis were randomly divided into treatment group and control group.25 patients in treatment group were treated by CTX (8~10 mg·kg-1·d-1),prednisone (1.5~2.0 mg·kg-1·d-1) and dipyridamole (1~2 g·kg-1·d-1);23 patients in control group were treated only by prednisone and dipyridamole with the same dosage as treatment group,theraputic effects were abserved and compared after 4 treatment courses.Results The total effective rate in treatment group was 96.0%, which was significant higher than that (82.6%) in control group (P<0.05).There were significant differences in urinary protein of 24h,serum albumin,TC,TG before and after treatment in both groups (P<0.05 or P<0.01),and the efficacy in treatment group was superior to that of control group (P<0.01).Conclusion Cyclophosphamide with lowdose and longer intermission has good therapeutic effect on nephrotic syndrome purpuric nephritis in children, with few side effect. ......

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