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目的观察环磷酰胺与雷公藤多甙治疗幅童难治性肾病综合征疗效、不良反应和复发率。方法难治性肾病综合征患儿55例,随机分成两组,环磷酰胺(CTX)组30例:给予CTX 8~12mg/kg静脉滴注,1次/d,连用2天为1个疗程,每2~4周应用1个疗程,连用6~10个疗程,累积量小于200 mg/kg;雷公藤多甙(TⅡ)组25例:给予TⅡ1 mg/(kg.d),分3次口服,每天最大量30 mg,疗程3个月。所有患儿给予泼尼松1 mg/(kg.d),分3次口服,4周后改为隔日顿服,并逐渐减量,其余用药相同。结果环磷酰胺组疗效优于雷公藤多甙组(χ2=4.30,P<0.05),近期不良反应少,复发率低(χ2=4.86,P<0.05)。结论环磷酰胺冲击治疗儿童难治性肾病综合征,适于在基层首选使用。
Objective To observe the efficacy, adverse reactions and recurrence of cyclophosphamide and tripterygium polyglucoside in the treatment of children with refractory nephrotic syndrome. Methods Fifty-five children with refractory nephrotic syndrome were randomly divided into two groups: 30 cases in CTX group: intravenous infusion of CTX 8-12 mg / kg once daily for 2 days for 1 course , Every 2 to 4 weeks to apply a course of treatment, continuous use of 6 to 10 courses, the cumulative amount of less than 200 mg / kg; Tripterygium glycosides (T Ⅱ) group of 25 patients: given T Ⅱ 1 mg / (kg.d) Oral, the maximum daily dose of 30 mg, treatment for 3 months. All children given prednisone 1 mg / (kg.d), 3 times orally, 4 weeks later changed to Dayton Dayton clothing, and gradually reduced, the rest of the same medication. Results The efficacy of cyclophosphamide group was better than that of tripterygium glycosides group (χ2 = 4.30, P <0.05). There were few adverse reactions and low recurrence rate in the cyclophosphamide group (χ2 = 4.86, P <0.05). Conclusion Cyclophosphamide shock treatment of refractory nephrotic syndrome in children, suitable for primary use.