摘要
目的 :探讨环孢霉素A治疗儿童难治性肾病 (RNS)的疗效。方法 :对 1998年 8月～ 2 0 0 2年 4月收住院的 14例RNS患儿进行CsA治疗后的临床分析。男性 12例 ,女性 2例 ,年龄 2 .5～ 12岁 ,病程 4个月～ 9年。激素依赖 12例 ,激素无效 2例。治疗前单用激素 4例 ,激素联合环磷酰胺 (Cyclophosphamide ,CTX) 10例。CsA4～ 5mg/kg .d ,强的松龙 1.0～ 1.5mg/kg隔日 ,疗程 12个月。结果 :12 / 14获完全缓解 ,2 / 14例部分缓解。根据肾活检病理分为微小病变 (MCNS)与IgM肾病 (IgMN)两组 ,完全缓解率分别为 83.3%和 87.5 % ,统计学无显著差异。血浆白蛋白和血胆固醇水平在治疗后与治疗前比较存在显著性差异 (P <0 .0 1)。 14例患儿CD4与CD8比值治疗前后增加具有统计学意义 (P <0 .0 1)。结论 :中小剂量CsA治疗RNS是安全和有效的 。
Objective: To study the effect of cyclosporine A in treating childhood refractory nephrotic syndrome(RNS). Methods: Fourteen patients, 12 males and 2 females, aged from 2.5 to 12 yrs admitted to our hospital from August 1998 to April 2002 , received therapy of cyclosporine A. Course of their diseases were from 4 months to 9 years. 12 cases were steroid dependent and 2 cases steroid resistant. 4 cases received steroid only and 10 cases received steroid combining with cyclophosphamide (CTX)before this therapy.The dosage of CsA and predinisolone were 4～5mg/kg.d and 1.0～1.5mg/kg.qod for 12 months. Results: Complete and partial remission were obtained in 12/14 and 2/14 respectively. Two groups were divided as minimal change nephrotic syndrome group and IgM nephropathy group according to pathological findings in the renal biopsy. Complete remission rate in the two groups were 83.3% and 87.5% respectively, without significant difference statistically ( P <0.01). There was significant difference statistically in the plasma albumin and cholesterol level before and after the treatment ( P <0.01). Level of CD 4 /CD 8 in the 14 case were increased and with significant difference statistically before and after the treatment ( P <0.01). Conclusion:one year of moderate dosage of cyclosporine A in treating children with refractory nephrotic syndrome is effective and safe. The rate of remission for IgMN and MCNS in children is high .
出处
《中国临床医学》
2003年第5期682-684,共3页
Chinese Journal of Clinical Medicine
关键词
环孢霉素A
儿童
难治性肾病综合征
治疗
Refractory nephrotic syndrome in children Cyclosporine A Treatment
