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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