环磷酰胺冲击治疗肾病型紫癜性肾炎患儿的疗效观察

目的探讨大剂量环磷酰胺（CTX）冲击治疗肾病综合征型紫癜性肾炎患儿的疗效。方法 30例肾病综合征型紫癜性肾炎患儿分为治疗组和对照组。对照组12例,给予泼尼松2mg/kg·d口服,双嘧达莫1～2mg/kg·d口服;治疗组18例,在对照组基础上加用CTX 8～12mg/kg·d,2天为1个疗程,每3周给予1个疗程,总累积量〈180mg/kg;4个疗程后比较两组疗效。结果治疗组完全缓解率（61.1%）明显高于对照组（16.7%,P〈0.05）,两组治疗前后24小时尿蛋白定量、血浆清蛋白、总胆固醇、甘油三酯等均有显著差异（P〈0.05）,且治疗组明显优于对照组（P〈0.01）,治疗组的激素不良反应亦明显低于对照组（P〈0.05）。结论环磷酰胺冲击治疗肾病型紫癜性肾炎较单用泼尼松疗效好,不良反应少。

Effect of cyclophosphamide pulse therapy on children with nephritic syndrome purpuric nephritis

Objective To investigate the effect of cyclophosphamide（CTX）pulse therapy on children with nephritic syndrome purpuric nephritis.Methods 30 cases of children with nephrotic syndrome purpura nephritis were divided into treatment group and control group.The control group of 12 patients received prednisone 2mg/kg.d oral dipyridamole 1-2mg/kg·d orally.Treatment group of 18 patients in the control group based on the use CTX8-12mg/kg·d,2 das a course of treatment,every 3 weeks for a course of treatment,total cumulative amount of〈180mg/kg.The efficacy was compared between the two groups after 4 courses of treatment.Results The complete remission proportion（61.1%）of treatment group was significantly higher than that of control group（16.7%）（P〈0.05）.There were significant differences（P〈0.05）in 24 hurinary protein,plasma albumin,total cholesterol,triglycerides between the two groups before and after the treatment.The treatment group was significantly better than the control group（P〈0.01）.The adverse effects of the hormone of treatment group were significantly lower than that of the control group.Conclusion Cyclophosphamide treatment of nephrotic purpura nephritis is relatively better in comparison with prednisone alone,and has lesser adverse reactions.