小儿难治性肾病３８例疗效分析大同市城区人民医院（０３７００４）郝妙兰小儿难治性肾病综合征的治疗迄今仍较困难。我们从１９７５年起采用中长程泼尼松加短程小剂量环磷酰胺（ＭＴＸ）联合治疗了３８例小儿难治性肾病，并逐一进行了随访。现将结果报告如下。临床资料一、一般资料：男２９例，女９例。就诊年龄６～７岁１４例；７～１０岁１８例，１０～１４岁６例。住本院前病程均大于６个月，其中６～１２月的１２例，１２～２４个月的２１例，大于２４个月５例，最长２．５年。均为复发型病例。最少每年发作２次，多则达５次，平均２．７次。３８例中单纯性肾病２７例，其中１２例对激素为部分效应，５例为激素依赖，有效但频繁复发１０例，余ｌ１例肾炎型肾病中２例无效应，９例为部分效应。均符合１９８１年全国小儿肾病科研协作组制定的临床标准。二、治疗过程：３８例入院后均先服用强的松２ｍｇ／ｋｇｄ，待临床症状消失、血生化恢复正常后，激素开始逐渐减量，采取顿服维持，总疗程９～１２个月。环磷酰胺一般在激素开始减量时加服，剂量为１００～２７６ｍｇ／ｋｇ。在用药的１～３周内每周查一次血常规，到第四周后，每１０～１４天查一次，如白细胞＜４×１０９／Ｌ即停药。３８例中有４ Pediatric refractory nephropathy in 38 cases Analysis of Datong City People’s Hospital (037004) Hao Miaolan Pediatric refractory nephrotic syndrome treatment is still more difficult. We have treated 38 children with refractory nephropathy with mid-long-term prednisolone plus short-term, low-dose cyclophosphamide (MTX) since 1975 and were followed up one by one. The results reported below. Clinical data First, the general information: 29 males and 9 females. There were 14 cases aged 6-7 years, 18 cases aged 7-10 years and 6 cases aged 10-14 years. Live in our hospital before the course of more than 6 months, of which 12 cases of 6 to 12 months, 12 to 24 months in 21 cases, more than 24 months in 5 cases, a maximum of 2.5 years. Are recurrent cases. At least 2 episodes per year, up to 5 times, an average of 2.7 times. Thirty-seven cases were simple nephropathy in 38 cases, of which 12 cases were partial hormones, 5 were hormone-dependent and 10 cases were frequent but frequent recurrences. There were 2 cases in 1 case of nephritis with no effect and 9 cases of partial nephropathy. Are in line with the 1981 national pediatric nephropathy research collaboration group to develop clinical standards. Second, the treatment process: 38 cases were admitted prednisone 2mg / kgd, until the clinical symptoms disappear, blood biochemistry returned to normal, the hormone began to taper, take Dayton clothes to maintain the total course of treatment of 9 to 12 months. Cyclophosphamide is generally added in the beginning of hormone reduction, the dose of 100 ~ 276mg / kg. 1 to 3 weeks in the medication check the blood routine once a week, to the fourth week, check every 10 to 14 days, such as white blood cells <4 × 109 / L that is discontinued. 4 of 38 cases