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目的 观察环磷酰胺 (CTX)冲击治疗原发性肾病综合征 (PNS)激素耐药病例的临床疗效及对血清可溶性白细胞介素 2受体 (sIL 2R)水平的影响。方法 以CTX治疗 15例激素耐药PNS患儿 ,CTX 8～ 12mg/kg静脉滴注 ,每日 1次 ,连用 2d为 1个疗程 ,每 2周应用 1疗程 ,共用 4～ 6疗程 ,累积剂量 6 0～ 12 0mg/kg。并应用ELISA方法测定给药前后血清sIL 2R水平。结果 15例激素耐药PNS患儿中 8例完全缓解 (5 3 3% ) ,1例部分缓解 ,总缓解率 6 0 0 %。 8例完全缓解者中 6例持续缓解 (2例 >2年 ;4例 >1年 )。CTX冲击后缓解病例血清sIL 2R水平下降。结论 CTX冲击治疗激素耐药PNS疗效较好 ,血清sIL 2R可作为监测用药效果的敏感指标
Objective To observe the clinical effect of cyclophosphamide (CTX) on steroid resistant patients with primary nephrotic syndrome (PNS) and its effect on serum soluble interleukin 2 receptor (sIL 2R) levels. Methods CTX treatment of 15 cases of hormone-resistant PNS children, CTX 8 ~ 12mg / kg intravenous infusion, once a day, once every 2d for a course of treatment, every 2 weeks for 1 course of treatment, sharing 4 to 6 courses, the cumulative dose 6 0 ~ 120mg / kg. Serum sIL 2R level was measured by ELISA before and after administration. Results In 15 cases of steroid-resistant PNS, 8 cases were completely relieved (53.3%), 1 case partially relieved, and the total remission rate was 600%. Six of eight patients with complete remission continued to remission (2 patients> 2 years; 4 patients> 1 year). Serum sIL 2R levels decreased after CTX shock therapy. Conclusion CTX shock treatment of hormone-resistant PNS better effect, serum sIL 2R can be used as a sensitive indicator of drug efficacy monitoring