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本文采用大剂量环磷酰胺冲击疗法治疗22例小儿难治性肾病,对其疗效和副作用进行观察。方法:环磷酰胺按500m8/m~2·次,每4周静脉注射一次,共8～12次,总剂量不超过300mg/kg。结果:显效15例,有效4例,无效2例,放弃治疗1例,总有效率达86.4％(19/22),尤其对微小病变及系膜增殖性肾小球肾炎疗效显著,对局灶节段性肾小球硬化、膜性肾炎和膜性增殖性肾小球肾炎亦有一定疗效。随访13～27月,平均20月,两例复发(2/22),占9.1％。副作用有轻度外周血白细胞计数降低,恶心呕吐,脱发等,未发现出血性膀胱炎及肝肾功能损害。结论:大剂量环磷酰胺冲击疗法治疗22例小儿难治性肾病,确有疗效可靠,价格低廉,副作用少等优点,值得临床进一步推广应用。
In this paper, high-dose cyclophosphamide shock therapy in 22 children with refractory renal disease, its efficacy and side effects were observed. Methods: cyclophosphamide 500m8 / m ~ 2 times, once every 4 weeks intravenous injection, a total of 8 to 12 times, the total dose does not exceed 300mg / kg. Results: 15 cases were markedly effective, 4 cases were effective, 2 cases were ineffective and 1 case was abandoned. The total effective rate was 86.4% (19/22), especially for minimal change and mesangial proliferative glomerulonephritis. Segmental glomerulosclerosis, membranous nephritis and membranous proliferative glomerulonephritis also have a certain effect. Follow-up from 13 to 27 months, an average of 20 months, two cases of recurrence (2/22), accounting for 9.1%. Side effects of mild peripheral white blood cell count decreased, nausea, vomiting, hair loss, etc., did not find hemorrhagic cystitis and liver and kidney dysfunction. Conclusion: High-dose cyclophosphamide shock therapy for 22 cases of pediatric refractory nephropathy, indeed reliable, inexpensive, less side effects, etc., worth further promotion of clinical application.