环磷酰胺大剂量冲击疗法和隔日小剂量连续给药法对难治性肾病综合征的疗效对比

目的 对比环磷酰胺大剂量冲击疗法和隔日小剂量连续给药法对难治性肾病综合征的疗效及不良反应. 方法 整群选取于2013年4月—2014年10月间入该院治疗的难治性肾病患者68例,随机分为研究组和对照组,各34例.所有患者每天口服泼尼松1 ㎎/㎏,同时,研究组以大剂量环磷酰胺冲击治疗;对照组以小剂量环磷酰胺隔日一次.连续治疗6个月. 定期回访,比较治疗前、治疗后血清白蛋白、尿蛋白定量、血肌酐、血清胆固醇水平,并记录不良反应. 结果 除血肌酐外,对照组及研究组治疗前后血清白蛋白、尿蛋白定量、血清胆固醇均有所缓解,治疗后,研究组各指标改善程度显著高于对照组,组间比较,t分别为3.281、4.274、5.283,P<0.05. 研究组仅3例患者发生不良反应,远小于对照组24例,其中肝功能损害、脱发及恶心呕吐等组间比较差异有统计学意义,P<0.01. 结论 大剂量环磷酰胺冲击疗法治疗难治性肾病的疗效明显优于隔日小剂量连续给药法,且副作用小,安全性高.

Comparison of Curative Effect of Pulse Therapy of High Dose of Cyclophos-phamide and Day Low-dose Continuous Dosing Method in Treatment of Refractory Nephritic Syndrome

Objective To compare the curative effect and adverse reactions of pulse therapy of high dose of cyclophos-phamide and day low-dose continuous dosing method in treatment of refractory nephritic syndrome. Methods 68 cases of patients with refractory nephritic syndrome treated in our hospital from April 2013 to October 2014 were selected and ran-domly divided into two groups with 34 cases in each, all patients were given oral prednisone of 1 mg/ kg daily, at the same time, the research group were treated with pulse therapy of high dose of cyclophosphamide, the control group were treated with low-dose cyclophosphamide once every other day for 6 months of treatment continuously, the patients were followed up regularly, the serum albumin, urine protein quantitation, serum creatinine and serum cholesterol levels before and after treatment were compared and the adverse reactions were recorded. Results In additional to serum creatinine, the serum al-bumin, urine protein and serum cholesterol before and after treatment of the two groups were relieved, after treatment, the improvement degrees of various indicators in the research group were obviously higher than those in the control group, t was respectively 3.281,4.274 and 5.283 by comparison between groups P<0.05. The adverse reaction occurred to only 3 cases in the research group, which were far fewer than those in the control group (24 cases), the differences in the liver function damage, hair loss and nausea and vomiting between the two groups were statistically significant P<0.01. Conclusion The curative effect of pulse therapy of high dose of cyclophosphamide in treatment of refractory nephritic syndrome is obviously better than that of the day low-dose continuous dosing method with small side effect and high security.