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目的探讨大剂量环磷酰胺(CTX)联合强的松治疗肾病综合征型紫癜性肾炎患儿的疗效。方法肾病综合征型HSPN患儿42例,按随机数字表法随机分为治疗组(23例)和对照组(19例),治疗组采用口服强的松片联合大剂量CTX冲击治疗,对照组仅口服强的松片治疗,评价CTX冲击治疗的效果。结果治疗组患儿的完全缓解率为65.2%,总体缓解率为95.7%,对照组患儿的完全缓解率为15.8%,总体缓解率为68.4%,治疗组完全缓解率及总体缓解率高于对照组,差异有统计学意义(P<0.05);通过14 w的治疗,两组的24 h尿蛋白、血尿素氮(BUN)、血肌酐(Scr)、总胆固醇(TC)和甘油三酯(TG)的水平均有不同程度下降,治疗组明显优于对照组(P<0.05);血浆白蛋白(ABL)水平均有不同程度上升,治疗组优于对照组(P<0.05);治疗组患儿的不良反应发生率亦明显低于对照组(P<0.05)。结论环磷酰胺冲击治疗儿童肾病综合征型紫癜性肾炎较单独采用强的松片口服效果好,且不良反应较少。
Objective To investigate the effect of high dose cyclophosphamide (CTX) combined with prednisone on children with nephrotic syndrome purpura nephritis. Methods Forty-two children with nephrotic syndrome (HSPN) were randomly divided into treatment group (n = 23) and control group (n = 19) according to random number table. The treatment group was treated with oral prednisone tablets and high dose CTX. Only oral prednisone treatment, evaluation CTX impact treatment. Results The complete remission rate was 65.2% in the treatment group and the overall remission rate was 95.7%. The complete remission rate was 15.8% in the control group and the overall remission rate was 68.4%. The complete remission rate and overall remission rate in the treatment group were higher than those in the control group Control group, the difference was statistically significant (P <0.05); after 14 w treatment, 24 h urinary protein, blood urea nitrogen (BUN), serum creatinine (Scr), total cholesterol (TC) and triglyceride (P <0.05). The level of plasma albumin (ABL) increased to some extent in the treatment group than in the control group (P <0.05). The levels of serum TG and TG in the treatment group were significantly lower than those in the control group Adverse reactions in children were also significantly lower than those in the control group (P <0.05). Conclusion Cyclophosphamide shock treatment of children with nephrotic syndrome purpura nephritis oral prednisone tablets alone than good, and fewer adverse reactions.