激素联合环孢素A与单独激素治疗儿童激素耐药型肾病综合征的疗效比较

发布时间：2018-05-18 20:13

本文选题：原发性肾病综合征 + 激素耐药型肾病综合征　；参考：《福建医科大学》2012年硕士论文

【摘要】：目的：原发性肾病综合征（primary nephrotic syndrome，PNS）是儿童常见的肾小球疾病。根据患儿对糖皮质激素治疗的反应，PNS被分为激素敏感型肾病综合征（steroid-sensitive nephrotic syndrome，SSNS）和激素耐药型肾病综合征（steroid-resistant nephrotic syndrome，SRNS）。80～90％的PNS患儿对糖皮质激素（以下简称激素）敏感，预后良好；但是，10～20％的PNS患儿对激素耐药，其中大约30～40%逐渐进展至终末肾（end-stage renal disease，ESRD）。儿童SRNS的病因与发病机制不完全明确，尚无统一的治疗方案。激素联合环孢素A（Cyclosporine，CsA）与单独激素治疗儿童SRNS的疗效比较目前尚不完全清楚。本研究旨在比较激素联合CsA与单独激素治疗儿童SRNS的疗效。方法：对2005年12月至2011年12月在南京军区福州总医院儿科收治的26例SRNS儿童进行了回顾性分析。结果：8例单独激素治疗的SRNS患儿首次复发距初治缓解时间是11～98天。13例激素联合CsA治疗完全缓解的患儿中7例出现复发，首次复发距初治缓解时间是20～417天。激素联合CsA治疗与单独激素治疗相比，首次复发距初治缓解时间长、复发率低。激素联合CsA治疗3个月的完全缓解率为66.67%，总缓解率为88.89%，治疗12个月时复发率为46.2%。CsA诱导完全或部分缓解时间是4～90天。结论：在维持缓解时间和复发率方面，激素联合CsA治疗儿童SRNS优于单独激素治疗。
[Abstract]:Objective: primary nephrotic syndrome (PNS) is a common glomerular disease in children. According to the response of children to glucocorticoid therapy, they were divided into steroid-sensitive nephrotic syndrome (steroid-sensitive nephrotic syndrome) and steroid-resistant nephrotic syndrome (SRNS.80%). 90% of PNS children were sensitive to glucocorticoid (hereinafter referred to as glucocorticoid) and had a good prognosis. However, 1020% of PNS patients were steroid resistant, and about 30% or 40% of them gradually advanced to end-stage renal disease (ESRD). The etiology and pathogenesis of SRNS in children are not completely clear and there is no unified treatment plan. The effect of corticosteroids combined with cyclosporine (CSA) on SRNS in children is still unclear. The purpose of this study was to compare the efficacy of hormone combined with CsA and hormone alone in the treatment of SRNS in children. Methods: from December 2005 to December 2011, 26 cases of SRNS children in Fuzhou General Hospital of Nanjing military region were retrospectively analyzed. Results the time of first relapse to initial remission was 1198 days in 8 cases of SRNS treated by hormone alone. Among 13 cases of complete remission treated by hormone combined with CsA, 7 cases recurred, and the time of first relapse to initial remission was 20417 days. Compared with single hormone therapy, hormone combined with CsA has a longer time to first relapse and lower recurrence rate. The complete remission rate of hormone combined with CsA for 3 months was 66.67 and the total remission rate was 88.89. After 12 months of treatment, the relapse rate was induced by 46.2%.CsA and the complete or partial remission time was 40.90 days. Conclusion: in maintaining remission time and relapse rate, hormone combined with CsA is superior to hormone alone in the treatment of SRNS in children.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.9

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