环磷酰胺治疗局灶节段性肾小球硬化疗效观察

目的观察环磷酰胺(CTX)治疗局灶节段性肾小球硬化(FSGS)的临床疗效。方法随访观察58例临床表现为肾病综合征的FSGS患者对CTX和激素治疗的疗效,58例FS-GS中有16例单予激素治疗(A组),24例激素治疗8周无效后加用CTX治疗(B组),18例确诊后同时予激素和环磷酰胺治疗(C组)。结果C组和B组的总缓解率(PR加CR)分别为67%和62%,显著高于A组(44%);C组缓解时间(10.46±2.34)周显著短于A组的(18.46±2.53)周和B组的(14.46±2.47)周;随访期A组复发率(44%)高于C组(17%)和B组(12%)。使用CTX治疗近期不良反应虽然较单用激素多,但均能耐受,没有因出现严重不良反应需要停药的情况。结论联合CTX和激素治疗原发性FSGS,可提高临床缓解率,同时减少复发率,保护肾功能。

Clinical curative effect observation of cyclophosphamide on focal segmental glomerulosclerosis

Objective It is to observe the clinical curative effect of cyclophosphamide(CTX) on focal segmental glomerulosclerosis(FSGS).Methods The curative effect of CTX and hormone on 58 FSGS patients whose clinical situation was nephrotic syndrome was followed up and observed.58 cases were divided into three groups.16 cases were in group A and treated with hormone only.24 cases were in group B and added CTX after hormone treating inefficacy.18 cases were in group C and treated with hormone and CTX simultaneously after final diagnosis.Results The complete remission and partial remission rates in group C was 67% and that in group A was 62% and they were both significantly higher than that in group A(44%).The remission time in group C was(10.46±2.34) weeks and significantly shorter than that in group A((18.46±2.53) weeks) and that in group B((14.46±2.47) weeks).In follow-up period,the relapse rate in group A was 44% and higher than that in group B(12%) and that in group C(17%).The untoward reaction in the near future of CTX was more than that of hormone,but the treatment was well tolerated and no patient appeared requiring discontinuation because of untoward reaction.Conclusion CTX combined with hormone can heighten clinical remission rate and decrease relapse rate at the same time to protect renal function.