环孢霉素A和环磷酰胺治疗以难治性肾病为表现的IgM肾病临床疗效比较  

Comparison of cyclosporine A and cyclophosphamide in the treatment of IgM nephropathy clinically presenting as refractory nephritic syndrome in children

作　　者：罗苇 冯仕品 王莉 谢敏 张伟 李莎 

机构地区：[1]成都市妇女儿童中心医院肾内科,四川成都610091

出　　处：《四川医学》2013年第11期1624-1626,共3页Sichuan Medical Journal

基　　金：成都市卫生局科研基金支持(编号:2012007)

摘　　要：目的比较CsA与CTX静脉冲击联合激素治疗对以RNS为表现的IgM肾病的疗效。方法将34例以RNS为表现的IgM肾病患儿随机分两组,分别予CsA联用糖皮质激素治疗(CsA组)或CTX联用糖皮质激素治疗(CTX组),疗程至少12个月,观察各组的24h尿蛋白定量、血浆清蛋白、肌酐、胆固醇和不良反应,以及各组的有效率。结果两组患者各观察指标均较治疗前好转。CsA组和CTX组总有效率分别为81.3%、72.2%,P>0.05。完全缓解患儿中,CsA组平均尿蛋白转阴时间为(35.6±18.7)d,CTX组为(54.7±21.6)d,P<0.05;CsA组、CTX组尿蛋白反复率为36.4%、40.4%,P>0.05。两组患儿均无严重并发症发生。结论 CsA与CTX治疗以RNS为表现的IgM肾病疗效无明显差异,但CsA联合激素治疗组尿蛋白转阴时间短。Objective To contrast the clinical effect of cycloseporine A （CsA） and cyclophosphamide （CTX） treatment for immunoglobulin M nephropathy （IgMN） clinically presenting as refractory nephritic syndrome （RNS） in children. Methods 34 children with IgMN clinically presenting as RNS, were randomly divided into two groups, CsA combined with glucocorticoid group（the CsA group） or CTX combined with glucocorticoid group （the CTX group）, treatment at least 12 months. 24h urinary protein, serum albumin, serum cholesterol, serum creatinine, its side effects, and the effective rate of each group were observed. Results The total effective rate were 81.3 % （the C sA group） and 72. 2% （the CTX group）respectively, P 〉 0. 05. The patients of the two group got to complete remission at （35.6 ±18. 2） days and （54. 7± 21.6） days respectively, P 〈 0. 05. Conclusion For the patients that IgMN cinically presenting as RNS, the clinical effect of CsA would be similar with that of CTX. But the time of getting to complete remission of CsA might shorter than that of CTX.

关 键 词：难治性肾病 IGM肾病 环孢霉素A 环磷酰胺 

分 类 号：R692.3[医药卫生—泌尿科学]