论文部分内容阅读
儿童特发性肾病综合征(INS)在病理方面以微小病变(MCNS)最为常见,少数呈弥漫系膜增殖或局灶节段性肾小球硬化。近40多年来的医疗实践表明;90%的INS对糖皮质激素(激素)治疗敏感。但是沿用已久的8周激素标准疗法使INS缓解后,60%的病例在激素减量或停用之后不久又复发,其中一部分成为激素依赖型NS。另10%病例对初始激素治疗即呈现抵抗性,其中约半数发展为终末期肾功能衰竭。近年不少学者在INS治疗方面做了大量的工作,把INS的治疗向前推进了一步。一、MCNS初始激素治疗方案的选择: 对MCNS激素初始治疗方案的选择,是围绕以下三点治疗目的逐步展开的: 1.尽快地使NS缓解:APN(Arbeitsgemeinschaftfur Padiatrische Nephrologie)研究发现,MCNS对强的松的效应一般发生在治疗的第1～2周之后,在治疗8天之后有50%的病例蛋白尿消失(尿蛋白<4mg/m~2/
Children with idiopathic nephrotic syndrome (INS) in the pathological features of minimal change (MCNS) is the most common, a few were diffuse mesangial proliferation or focal segmental glomerulosclerosis. Nearly 40 years of medical practice have shown that 90% of INS is sensitive to glucocorticoid (hormone) treatment. However, following the well-established 8 weeks of hormone standard therapy to relieve INS, 60% of cases relapse shortly after hormone abstinence or discontinuation, some of which become hormone-dependent NS. The other 10% of cases showed initial resistance to hormone therapy, of which about half of the development of end-stage renal failure. In recent years, many scholars have done a great deal of work in the treatment of INS, and have taken INS treatment a step further. First, the choice of MCNS initial hormonal treatment options: The initial treatment options for MCNS hormones are built around the following three therapeutic purposes: 1. As soon as possible to alleviate the NS: APN (Arbeitsgemeinschaftfur Padiatrische Nephrologie) study found that MCNS strong The effects of pine generally occur after the first and second weeks of treatment, with 50% of cases of proteinuria disappeared after 8 days of treatment (urinary protein <4 mg / m 2 /