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目的观察环孢霉素A(CsA)治疗小儿难治性肾病的疗效。方法应用CsA治疗13例难治性肾病患儿,均服用CsA5～6mg/(kg.d)9个月,然后在3个月内逐步减量至停用,观察尿蛋白变化及副作用。结果9例患儿获完全缓解,3例部分缓解,总有效率达92.3%。6例患儿已结束疗程3～6个月,均无复发。进一步分析发现CsA对临床表现为单纯性肾病、激素依赖、组织学病变为微小病变或系膜增殖性肾小球肾炎的患儿疗效较好,而对肾炎性肾病、激素耐药、组织学病变为局灶节段性肾小球硬化的患儿疗效欠佳。结论CsA为小儿难治性肾病一有效的治疗药物。
Objective To observe the curative effect of cyclosporin A (CsA) on refractory nephropathy in children. Methods Thirteen children with refractory nephropathy were treated with CsA for 5-9 months (CsA 5-6 mg / (kg · d)) for 9 months, and then gradually reduced to disable within 3 months to observe urinary protein changes and side effects. Results Nine patients were completely relieved, 3 patients partially relieved, the total effective rate was 92.3%. 6 cases of children have completed the course of 3 to 6 months, no recurrence. Further analysis found that CsA is clinically manifest as simple nephropathy, hormone dependence, histological lesions of patients with minimal change or mesangial proliferative glomerulonephritis better effect, and nephritis nephropathy, hormone resistance, histological changes Focal segmental glomerulosclerosis in children with poor efficacy. Conclusion CsA is an effective treatment for children with refractory nephropathy.