环磷酰胺两种不同给药方法对小儿难治性肾病综合征的近期疗效观察  

THE RECENTLY CURATIVE EFFECT OBSERVATION OF INTRACTABLE PEDIATRIC NEPHROTIC SYNDROME TREATED BY TWO DIFFERENT METHODS OF CYCLOPHOSPHAMIDE MEDICATION

作　　者：李伟明[1] 徐辉[1] 肖昕[1] 侯燕明[1] 

机构地区：[1]清远市人民医院,广东清远511500

出　　处：《现代医院》2004年第6期26-27,共2页Modern Hospitals

摘　　要：目的　研究环磷酰胺 (CTX)的两种不同给药方法 ,对小儿难治性肾病综合征 (NS)的近期治疗效果 ,以选择最好的给药方法。方法　用药方法 :6 8例难治性肾病综合征分为两组 :①口服治疗组 35例 ,用药方法 :CTX片剂 2 5mg～ 3mg/kg·d ,一次性晨服 ,连续用药 8～ 12周 ,总量 2 0 0mg～ 2 5 0mg/kg。②静脉间歇冲击治疗组 33例 ,用药方法 :CTX针剂静脉给药 ,每次 8～ 10mg/kg ,每天 1次 ,连用 2天 ,每 2周为 1个疗程 ,连用 5～ 6个疗程 ,总量 80～ 12 0mg/kg。观察两组病人的近期治疗效果。结果　口服治疗组完全缓解 19例(占 5 4 2 8% ) ,其中复发 9例 (占 4 7 37% ) ,部分缓解 10例 ,未缓解 6例 ,总有效率 82 86 %。静脉间歇冲击治疗组完全缓解 2 9例 (87 88% ) ,其中复发 5例 (占 17 2 4 % ) ,部分缓解 3例 ,未缓解 1例。总有效率 96 97%。两组的总有效率比较无统计学意义 ,而完全缓解率及复发率比较具有统计学意义 (P <0 0 5 )。结论　对于小儿难治性NS选用免疫抑制剂CTX时 ,采用静脉间歇冲击治疗方法 ,效果好 ,复发率低 ,副作用较少 ,可作为首选方案。Objective To study two different methods of using cyclophosphamide(CTX) and choose the best method by observing recently curative effect of intractable pediatric nephrotic syndrome(NS) treated by two methods. Methods 68 cases of pediatric intractable NS divided into two groups. The first group: 35 cases of oral therapy method, each was given CTX tablet 2.5 mg～3 mg/kg·d by oral administration once on morning continuing 8～12 weeks added to 200 mg～250 mg/kg. The second group: 33 cases of intravenous intermittent hit therapy, each was given CTX 8～10 mg/kg·d by venous injection continuing 2 days every week and lasting 5～6 treatment courses (2 weeks a course), added to 80～120 mg/kg. Observe the recently curative effect of two groups. Results There were complete remission 19 cases (54.28%), partial remission 10 cases, no remission 6 cases in the first group. 9 relapsed in complete remission cases. Total effective rate was 82.86%. There were complete remission 29 cases (87.88%), partial remission 3 cases, no remission 1 case in second group. 5 relapsed in complete remission cases. Total effect rate was 96.97%. There was no statistics significance between total effective rates in two groups. But among completed remission and relapsed rate were opposite. Conclusions Using intravenous intermittent hit therapy method can be the first therapeutic scheme of treating intractable pediatric NS by taking immunosuppressant CTX because of its good therapeutic effect, low relapsed rate and few side effects.

关 键 词：环磷酰胺 给药方法 小儿 肾病综合征 CTX NS 

分 类 号：R726.92[医药卫生—儿科]