环孢素A、强的松与环磷酰胺治疗难治性肾病综合征临床研究

目的：探讨环孢素A(CSA)、强的松与环磷酰胺(CTX)联合治疗难治性肾病综合征的临床疗效、不良反应及复发率。方法：将我院收治并诊断为难治性肾病综合征的68例患者随机分为观察组和对照组，每组34例，观察组患者给予CSA 2.0～2.5 mg·kg-1·d-1，分两次服，连服2～3个月，完全缓解后每隔4周减量0.25～0...

Effects of cyclosporin A combing with prednisone,cyclophosphamide on refractory nephrotic syndrome

Objective To investigate the clinical efficacy, adverse effectsof cyclosporin A （CSA） combing with prednisone, cyclophosphamide （CTX） for refractory nephrotic syndrome, as well as patients’ and recurrence rate. Methods： A total of 68 patients withrefractory nephrotic syndrome were randomly divided into study group and control group with 34 cases in each group. The study group was given CSA at the dosage of 2 ～ 2.5 mg/kg, d, twice per day for consecutive 2-- 3 months. After symptoms were completely relieved, patients continued to take CSA at 0.25-0.50 mg/kg, d or prednisone at the dosage of 0.75 - 1 mg/kg, d for eight weeks. Intravenous infusion of 0.1 - 1.0 g CTX adding to 500 mL 5 % glucose was given every 3 weeks to 1 month. The control group was given prednisone at the dosage of 1 - 2 mg / kg. d and TWP 20mg / time, 3 times a day, Intravenous infusion of 0.1 - 1.0 g CTX adding to 500 mL 5% glucose was also given every 3 weeks to 1 month. Clinical efficacy, adverse reactions, relapse rate and serum creatinine before and after treatment, changes in serum albumin, 24h urinary protein were observed and compared. Results. After treatment, both groups showed significant improvement in indicators of renal function （P〈0. 05）, but more obviously in the study group （P〈0. 05）. The study group also showed significantly higher total effects, but lower recurrence rate than the control group （P〈 0.05）. No significant difference in incidence of adverse reactions was observed between the two groups （P 〉0.05）. Conclusions. With less adverse reactions, cyclosporin A （CSA） combing with prednisone and cy clophosphamide （CTX） is effective on refractory nephrotic syndrome.