ALTERNATIVE TREATMENT TO CORTICOSTEROIDS IN STEROID SENSITIVE IDIOPATHIC NEPHROTIC SYNDROME
ALTERNATIVE TREATMENT TO CORTICOSTEROIDS IN STEROID SENSITIVE IDIOPATHIC NEPHROTIC SYNDROME
复制标题
DOI：
10.1136/adc.71.6.522
复制
发表时间：
1994-12-01
影响因子：
5.2
通讯作者：
BARRATT, TM
中科院分区：
文献类型：
--
作者：
NEUHAUS, TJ;FAY, J;BARRATT, TM
本文回顾了1980年至1994年期间429例类固醇肾病综合征（SSNS）患儿在皮质类固醇激素治疗基础上使用替代免疫抑制剂的情况。222名儿童（52%）接受了至少一个疗程的替代治疗，98名（23%）接受了两个疗程，43名（10%）接受了三个疗程。196名儿童（46%）接受了环磷酰胺治疗; 181名儿童接受了替代治疗的第一个疗程，其中104名儿童（57%）接受了最后一个疗程（“最后一个疗程”）。56名儿童服用左旋咪唑，53名（12%）服用环孢菌素。15名环孢菌素治疗失败的儿童接受苯丁酸氮芥治疗。少数患者接受硫唑嘌呤或长春新碱治疗。10名儿童发生继发性类固醇抵抗，其中5名进展为慢性肾衰竭。急性并发症包括可逆性肾衰竭、败血症、腹膜炎、惊厥和脑血栓形成。有三人死亡。它的结论是，一半的转介儿童与SSNS被认为需要至少一个疗程的替代免疫抑制治疗，SSNS的治疗和并发症的副作用是罕见的，但偶尔致命的。
A review was undertaken of the use of alternative immunosuppressive treatment in addition to corticosteroids in a cohort of 429 children with steroid nephrotic syndrome (SSNS) between 1980 and 1994. Two hundred and twenty two children (52%) received at least one course of alternative treatment, 98 (23%) two, and 43 (10%) three. Cyclophosphamide was administered to 196 children (46%); in 181 it was the first course of alternative treatment and in 104 (57%) of those it was also the last ('final course'). Levamisole was given to 56 children and cyclosporin to 53 (12%). Fifteen children in whom cyclosporin failed were treated with chlorambucil. A few patients received azathioprine or vincristine. Ten children developed secondary steroid resistance, of whom five progressed to chronic renal failure. Acute complications included reversible renal failure, septicaemia, peritonitis, convulsions, and cerebral thrombosis. There were three deaths. It is concluded that half of the referred children with SSNS were deemed to require at least one course of alternative immunosuppressive treatment, and that side effects of the treatment and complications of SSNS are infrequent but occasionally fatal.