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依那普利(Enalapril)系血管紧张素转换酶抑制剂(ACEI)之一,目前广泛应用于治疗高血压和心力衰竭等,治疗儿童难治性肾病综合征报道较少,现将我院近年应用依那普利治疗儿童难治性肾病综合征16例报道如下。 临床资料 (1)对象:诊断标准均符合《全国小儿肾小球疾病临床分类和治疗建议》的修订意见,其中初治5例,复治11例。经常规激素治疗8周后无效应者共11例,部分效应5例,其中5例加用环磷酰胺治疗仍为无效。本组男9例,女7例。平均年龄6.44岁(2～13岁),平均病程6.61月(15天～4年),24小时平均尿蛋白3.881g(1.10～8.25g)。临床诊断单纯性肾病6例,肾炎性肾病10例。(2)治疗方法:停用环磷酰胺,激素减量,依那普利0.5～1mg/kg·d,分1～2次口服,疗程3个月,尿蛋白转阴2～3周后,适当减少剂量。(3)观察指标:治疗期间密切观察血压、尿蛋白、白细胞总数、肝
Enalapril is one of the angiotensin-converting enzyme inhibitors (ACEIs), which is widely used in the treatment of hypertension and heart failure. It has been reported in children with refractory nephrotic syndrome. Enalapril treatment of children with refractory nephrotic syndrome in 16 cases reported below. Clinical data (1) Subjects: Diagnostic criteria are in line with the “National Pediatric Glomerular Disease Clinical Classification and Treatment Recommendations,” the revised views, including 5 cases of initial treatment, retreatment 11 cases. There were 11 cases with no effect after routine hormone therapy for 8 weeks and 5 cases with partial effect, of which 5 cases were still ineffective with cyclophosphamide. The group of 9 males and 7 females. The average age was 6.44 years (range 2-13 years). The average course of disease was 6.61 months (15 days to 4 years). The average urinary protein in 24 hours was 3.881g (1.10-8.25g). Clinical diagnosis of simple nephropathy in 6 cases, nephritis in 10 cases. (2) treatment: disable cyclophosphamide, hormone reduction, enalapril 0.5 ~ 1mg / kg · d, 1 or 2 times orally, course of treatment for 3 months, urine protein negative 2 to 3 weeks, Properly reduce the dose. (3) observation indicators: close observation of blood pressure during treatment, urinary protein, total white blood cells, liver