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本文分析25例难治性肾病综合征经卡介苗(BCG)联合其他多种药物,包括激素和(或)细胞毒药物治疗的疗效。10例经肾活检示7例增殖性肾炎,2例局灶性硬化症(FGS),1例新月体肾炎。治疗后10例尿蛋白减至<0.2g/24h,11例<0.6g/24h,此21例尿常规和临床表现均恢复到正常。从BCG注射开始到尿蛋白缓解的间期为14～90(平均49.4±26.8)天。10例肾活检的病例中2例FGS疗效差,1例局灶性增殖性肾炎自动出院未观察疗效,余均明显缓解。 4例经随访,除1例FGS外,余3例坚持单用BCG者已缓解9月或以上。1例系膜增殖性肾炎单用BCG维持,已11个月未见复发。 BCG接种所以有效可能是由于其能促进单核吞噬细胞系统的活性,从而加强对免疫复合物的清除。
This article analyzes the efficacy of 25 refractory nephrotic syndromes treated with BCG in combination with a variety of other drugs, including hormonal and / or cytotoxic drugs. Ten cases had renal biopsy in 7 cases of proliferative glomerulonephritis, 2 cases of focal sclerosis (FGS) and 1 case of crescentic nephritis. After treatment, 10 cases of urinary protein reduced to <0.2g / 24h, 11 cases <0.6g / 24h, the routine and clinical manifestations of 21 cases returned to normal. The interval from the start of BCG injection to urine protein remission ranged from 14 to 90 (mean, 49.4 ± 26.8) days. In 10 cases of renal biopsy in 2 cases of FGS poor efficacy, 1 cases of focal proliferative glomerulonephritis were not discharged automatically observed efficacy, were significantly relieved. Four cases were followed up, except for one case of FGS, the remaining three cases of persistent BCG alone had been alleviated in September or more. One case of mesangial proliferative glomerulonephritis with BCG alone, no recurrence of 11 months. BCG vaccination so effective is probably due to its ability to promote mononuclear phagocyte system activity, thereby enhancing immune complex clearance.