环磷酰胺联合小剂量泼尼松治疗老年人原发性肾病综合征的临床观察

Cydophosphamide combined with low-dose prednisolone treatment of diabetic nephropathy

目的观察环磷酰胺针联合小剂量泼尼松治疗老年人原发性肾病综合征的疗效及安全性。方法采用回顾性分析,用环磷酰胺针联合小剂量泼尼松治疗64例患者,每组32例。两组均口服泼尼松片0.5 mg/kg.d,超过60 kg者,仍用30 mg/d,8周以后逐渐减量,每月减2.5 mg,10 mg/d维持治疗时间>6个月。其中治疗组环磷酰胺针0.8 g,加入生理盐水250 mL中,半个月1次×3次,1个月1次×3次,3个月1次×4次(总剂量为8.0 g)。分别检测治疗前、治疗后半个月、1个月、3个月、6个月、12个月、18个月的血浆白蛋白(Alb)、24 h尿蛋白定量(24 h Pro)等生化指标。结果治疗后治疗组总缓解率87.5%,对照组总缓解率65.6%。两组患者从治疗第3个月起血浆白蛋白(Alb)、24 h尿蛋白定量(24 h Pro)出现明显统计学差异(P<0.01,P<0.05)。结论环磷酰胺针联合小剂量泼尼松治疗老年人原发性肾病综合征较单用泼尼松治疗更有效,且安全、副作用小。

Objective To observe the needle combined with low dose cyclophosphamide prednisone in elderly patients with primary nephrotic syndrome of the efficacy and safety. Methods Retrospective analysis, with cyclophosphamide combined with low-dose prednisone treatment of needle 64 patients in each group 32 cases. Both groups of oral prednisone tablets 0.5mg/（kg. d）, more than 60 kg are still with 30 mg/d, 8 weeks after the gradual reduction of the monthly reduction 2.5 rag, 10mg / d maintenance therapy for〉 6 months. Cyelophosphamide treatment group needle 0.8g, add 250 ml of normal saline, 1 time every half month~ 3 times, 1 time every one month x 3 times a month, 1 time every three months x 4 times （total dose 8.0 g）. Were measured 0,0.5,1,3,6,12,18months, plasma albumin （Alb）, 24 h urinary protein （24 h Pro） and other biochemical markers. Results After treatment, overall response rate was 87.5% in the control group, the total response rate of 65.6%. Two patients from March of treatment serum albumin （Alb）, 24 h urinary protein （24 h Pro） statistically significant difference （P 〈 0.01, P 〈 0.05）. Conclusion acupuncture combined with low dose cyclophosphamide prednisone in elderly patients with nephrotic syndrome compared with prednisone alone is more effective, and safe, side effects.