环磷酰胺冲击治疗儿童难治性肾病综合征临床疗效观察

The clinical effect observation on refractory nephrotic syndrome in children with the impactcyclophosphamide

目的:探讨环磷酰胺冲击联合激素治疗儿童难治性肾病综合征(RNS)的临床疗效。方法:回顾性分析2010年1月—2012年12月采用环磷酰胺(CTX)冲击联合激素治疗RNS患者40例。随机分为对照组18例(常规激素治疗)和治疗组22例(环磷酰胺冲击联合激素治疗),对两组临床疗效、不良反应及治疗前、治疗后24 h尿蛋白定量、血浆白蛋白进行观察和比较。结果:治疗组患者中,完全缓解14例,部分缓解7例,未缓解1例;对照组患者中,完全缓解6例,部分缓解7例,未缓解5例。与对照组的总缓解率(72.2%)相比,治疗组的总缓解率(95.5%)明显增高(P<0.05)。治疗组出现胃肠道反应2例;对照组出现呼吸道感染2例,胃肠道反应3例。结论:大剂量环磷酰胺冲击加激素治疗难治性肾病综合征疗效显著,不良反应相对较小。

Objective：To study the clinical effect on refractory nephrotic syndrome（RNS） in children with the impact cy- clophosphamide combined with hormone. Methods ：Forty patients with RNS in our hospital from January in 2010 to December in 2012 were treated by impact cyclophosphamide combined with hormone by retrospective analysis. They were randomly divid- ed into control group （18 cases with conventional hormone） and treatment group （22 cases with impact cyclophosphamide com- bined with hormone）. The clinical curative effect, adverse reaction and 24 h urinary protein before and after treatment, plasma albumin of the two groups were observed. Results：The completely remission patients in treatment group were 14 cases, partial remission were 7 cases, and 1 case was no remission. In control group,6 cases patients were completely remission,7 cases were partial remission ,and 5 cases were no remission. Compared with the total remission rate of treatment group（95.5% ） was sig- nificantly higher than that of the control group（72.2% ） （P 〈 0.05）. In the treatment group,2 cases of patients had gastroin- testinal tract reaction. In patients with the control group,2 cases of patients had respiratory tract infection, and 3 cases of pa- tients had gastrointestinal tract reaction. Conclusion：Large dose of the impact cyclophosphamide combined with hormone had obviously therapeutic effect on refractory nephrotic syndrome, and adverse reaction was relatively small which was safety and worthy of application.