环孢素A治疗难治性肾病综合征的临床观察

目的：探讨环孢素A用于治疗难治性肾病综合征的临床疗效与价值。方法：选取2010年1月-2013年12月本院儿科确诊的难治性肾病综合征患者共46例,对所有患者使用环孢素A进行治疗,并对其治疗后每3个月实验室检查指标、症状改善及复发人数等情况进行记录。结果：治疗后,患者各项检查指标均显著优于治疗前,比较差异统计学意义（P〈0.05）;治疗后不同病理类型疾病缓解率分别为75.0%,91.7%,88.9%,治疗效果显著;患者中,有2例微小病变患者、1例系膜增生性肾小球肾炎患者使用半年环孢素A后无效,病情迁延不愈,调整剂量后再次使用环孢素A,疾病均得到一定控制,疗效较好。结论：使用环孢素A对难治性肾病综合征进行治疗疗效显著,可发挥免疫抑制作用,在疾病治疗中抑制自身免疫反应,有效减少炎性反应。短期疗效显著,不良反应较少,安全系数较高。可在短时间内缓解患者症状,有效改善蛋白尿且长期预后较好。用药时严格检测药物血药浓度及肝肾功能可提高用药安全性,降低不良反应发生率。

Clinical Observation of Cyclosporine A in the Treatment of Refractory Nephrotic Syndrome

Objective： To investigate the curative effect and clinical value of cyclosporine A in the treatment of refractory nephrotic syndrome.Method： 46 refractory nephrotic syndrome patients were selected from January 2010 to December 2013 in our hospital pediatric, all the patients were treated with cyclosporine A, and the index of laboratory examination after treatment for every three months, improvement of symptoms and the number of recurrence were recorded. Result： After treatment, the indexes were significantly better than before treatment, the difference was statistically significant （P〈0.05）; different pathological types of disease remission rates were 75%, 91.7%, 88.9% after treatment, the treatment effect was obvious; there were 2 patients with minimal change disease, 1 patient with mesangial proliferative glomerulonephritis with cyclosporin A treatment six months was invalid, illness defer did not heal, after adjusting the dosage of cyclosporine A again, the disease could be controlled, curative effect was better.Conclusion： The use of cyclosporine A in the treatment of refractory nephrotic syndrome treatment curative effect is distinct, and can play a role in immune suppression, suppression of autoimmune reaction in the treatment of diseases, effectively reduce the inflammatory reaction. This method is of the short-term curative effect, less adverse reactions, higher safety factor, and can alleviate symptoms in a short period of time, effectively improve the proteinuria and long-term prognosis. Use strict detection of drug blood concentration and liver and kidney function can improve the safety, reduce the incidence of adverse reaction.