环孢霉素A治疗以肾病综合征为表现的局灶节段性肾小球硬化的疗效观察  

Effect of cyclosporine A treatment for focal segmental glomerulus sclerosis presenting as nephrotic syndrome in children

作　　者：朱光华[1] 何威逊[1] 俞全胜[1] 罗运九[1] 任志德[1] 

机构地区：[1]上海市儿童医院,上海200040

出　　处：《临床儿科杂志》2002年第4期211-213,共3页Journal of Clinical Pediatrics

摘　　要：为了观察环孢霉素A(CyA)对以肾病综合征为表现的局灶节段性肾小球硬化 (FSGS)的疗效。对11例病儿进行治疗 ,年龄2岁～11岁。CyA开始治疗剂量3mg/ (kg·d) ,1周后加至5mg/ (kg·d) ,以后根据CyA血浓度调整剂量 ,维持CyA血浓度在100μg/L～200μg/L。用药6个月～9个月后逐渐减量 ,总疗程12个月。结果显示完全缓解7例 (63.6% ) ,部分缓解3例 (27.3 % ) ,无效1例 (9.1% ) ,CyA治疗激素耐药FSGS ,总有效率高达91 % ;5例治疗后尿视黄醇结合蛋白 (RBP)升高。提示CyA治疗以肾病综合征为表现的FSGS在临床上具有良好疗效 。To observe the clinical effect of cyclosporine A(CyA) treatment for focal segmental glomerulus sclerosis(FSGS) clinically presenting as nephrotic syndrome in children,11 nephrotic children with FSGS,aged from 2 to 11 years,were planned to received CyA treatment.The general therapeutic programme included as follows:3mg/(kg·d)of CyA was given to each case in the firts week,following by a continuous dosage of 5 mg/(kg·d)from next weed for as long as 6-9 months.In this period,the most available therapeutic dosage should be adjusted by the way of monitoring serum CyA concentration of 100-200 μg/L.Subsequently,the dosage given could be gradually drawn down and finally stopped in 12 mon_ths.The results showed that complete remission was obtained in 7 cases of them(63.6%),partial resmission in 3 cases(27.3%)and no effectiveness in 1 case(9.1%),demonstrating a total effectiveness rate of 91%.Furthermore,urinary retind binding protein (RBP) was positively examined in 5 cases.From these results,it was suggested that CyA treatment actually has a good therapeutic response in nephrotic children with FSGS and urinary RBP could be considered as an index of judging the adverse action of CyA in these patients.

关 键 词：肾病综合征 局灶节段性肾小球硬化 环孢霉素A 治疗 儿童 

分 类 号：R726.9[医药卫生—儿科]