环孢素联合泼尼松治疗原发性局灶节段性肾小球硬化的临床观察

目的：观察环孢素联合糖皮质激素与环磷酰胺联合糖皮质激素治疗原发性局灶节段性肾小球硬化（FSGS）的疗效及不良反应。方法将42例原发性FSGS患者随机分为环孢素联合糖皮质激素组（观察组）与环磷酰胺联合糖皮质激素组（对照组），每组各21例，观察治疗前和治疗后第1、3、6、12个月的24h尿蛋白定量、血白蛋白、血尿素氮、血肌酐等临床指标及不良反应。结果两组患者治疗后24h尿蛋白定量明显减少，血白蛋白升高，且观察组优于对照组，差异均有统计学意义（P〈0.05）。治疗12个月后，观察组总有效17例，对照组总有效10例，两组疗效比较，差异有统计学意义（P〈0.05）。观察组5例发生不良反应，对照组8例发生不良反应，两组不良反应发生率比较，观察组明显低于对照组（P〈0.05）。结论环孢素联合糖皮质激素治疗原发性FSGS的疗效优于环磷酰胺联合糖皮质激素，且不良反应少。

ObjectiveTo observe the efficacy and adverse effects of cyclosporine combined with glucocorticoid in treatment of focal segmental glomerularsclerosis.Methods42 patients with focal segmental glomerularsclerosis were enrolled in this study.They were randomized into groups of cyclosporine combined with glucocorticoid therapy group（test group,21 cases）and cyclophosphamide combined with glucocorticoid therapy group （control group,21 cases）.The 24-hour urine protein,serum albumin,serum urea nitrogen,serum creatinine and other indicators of treatment were recorded and compared at the first month,the third month,the sixth month and the twelfth month. Adverse effects were recorded.ResultsUrine protein of the groups were significantly decreased（P〈0.05）compared with pre-treatment,and serum albumin levels were significantly higher than before treatment（P〈0.05）,and the treatment group was better than the control group（P〈0.05）. The effective rate of the treatment group was higher than that of the control group（P〈0.05）. The incidence of adverse reactions in the treatment group was lower than that in the control group（P〈0.05）. ConclusionOur findings may suggest that cyclosporine combined with glucocorticoid is more effective and safer than cyclophosphamide combined with glucocorticoid in treatment of focal segmental glomerularsclerosis.