环孢霉素A在小儿难治性肾病中的应用——附26例分析

TREATMENT OF CYCLOSPORIN A IN CHILDREN WITH REFRACTORY NEPHROTIC SYNDROME

观察分析口服ＣｓＡ治疗２６例小儿难治性肾病综合征（系膜增殖性肾小球肾炎１５例、微小病变８例、系膜增殖并局灶性硬化２例）的疗效。在强的松减量的过程中，给以ＣｓＡ口服，按５ｍｇ／（ｋｇ·ｄ），疗程３～６个月，并监测血浓度。２６例患儿经治疗后，住院期间（１个月）尿蛋白转阴者２１例（８０．７７％），尿蛋白减少者３例（１１．５４％），无效者２例（７．６９％），总有效率达９２．３１％（ｔ＝５．２３４，Ｐ＜０．０１），显效时间为７～２３天，平均１３天。ＣｓＡ是替代激素治疗该类病人的较好方法之一，尤其是临床表现为激素依赖及Ｃａｓｈｉｎｇ征明显，且病理类型为ＭｓＰＧＮ和ＭＣＮＳ者疗效好。

The authors reported that 26 cases of children with refractory nephrotic syndrome were treated with cyclosporin A,which included 15 cases of MsPGN, 8 cases of MCNS, and 2 case of MsPGN with focal sclerosis.Cyclosporin A was given to each patient according to 5 mg/(kg·d) during dosage of prednison was diminished.Thewhole was about 3～6 months.The plasma concentration of CsA was supervised in the course of this therapy.Patient's proteinuria turn to negtive in 21 cases(80.77%),to reduce in 3 cases(11.54%),not change in 2 cases(7.69%) in the total 26 cases after treatment for one month in the hospital.The overall response rate was 92.31%( t =5.234, P <0.01).The response time was 7～23 days,the average was 13 days.CsA is the one of effective substitute forthis type diseases,especially in MsPGN and MCNS which aresteroiod dependence and have heavy Cushing syndrome.But it is no effective in FSGS.