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口服大剂量强的松对微小病变型肾病综合征的治疗常能逆转,但相当多病人可发生严重副作用,尤其是频繁复发的患者。作者试用一种新治疗方案,即开始用静脉注射甲基强的松龙脉冲治疗连续3天,随后用小剂量强的松口服。 11例患者年龄为4～46岁,均住院观察。全部病例都是肾病综合征,有低白蛋白血症(≤25g/L)及蛋白尿(≥40 mg/m~2/h),7例肾活检经光镜及电镜检查证明为轻微病变肾小球改变,经IgG及转铁蛋白的清除试验示所有病例都为高度选择性蛋白尿。治疗后,如连续3天无蛋白者为缓解,7天内连续3次检查发现蛋白尿≥4 mg/m~2/h为复发,患者于首次
Large doses of prednisone oral treatment of minimal change nephrotic syndrome can often be reversed, but a considerable number of patients may have serious side effects, especially in patients with frequent recurrence. The authors piloted a new treatment that began with intravenous methylprednisolone pulse treatment for 3 consecutive days, followed by a small dose of prednisone oral. 11 patients aged 4 to 46 years old, were hospitalized. All cases were nephrotic syndrome with hypoalbuminemia (≤25 g / L) and proteinuria (≥40 mg / m 2 / h). Seven renal biopsies were confirmed by light and electron microscopy as mild lesions of the kidney Glomerular changes, clearance tests with IgG and transferrin showed that all cases were highly selective proteinuria. After treatment, if no protein for 3 consecutive days were relieved, 3 consecutive days within 7 days revealed proteinuria ≥ 4 mg / m ~ 2 / h for recurrence, the patient for the first time