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目的 探讨环磷酰胺冲击疗法对难治性肾病综合征的疗效。方法 选择２０ 例难治性肾病综合征患儿，分别给予环磷酰胺（ＣＴＸ）每次１２ｍｇ／ｋｇ，加入１０ ％ 葡萄糖溶液２５０ｍｌ 中静滴，每隔３ ～４ 周１ 次，连用８～１０ 次，后改为每３ 个月１ 次，维持缓解半年至１ 年后停药。累积量１２０～１５０ｍｇ／ｋｇ，ＣＴＸ 冲击同时联合应用强的松方案常规治疗。结果 冲击治疗后，血浆总蛋白及白蛋白有不同程度的升高，２４ 小时尿蛋白定量有明显降低，冲击治疗前后有显著性差异（ Ｐ＜ ０－０１） 。血肌酐（ＳＣｒ）及内生肌酐清除率（ＣＣｒ） 冲击治疗前后无显著性差异（ Ｐ＞ ０－０５） 。随着冲击次数增加，完全及部分缓解例数增多。结论 环磷酰胺冲击疗法对难治性肾病可获较好疗效，尤其对频繁复发和激素依赖的患儿治疗效果好。
Objective To investigate the effect of cyclophosphamide shock therapy on refractory nephrotic syndrome. Methods Twenty children with refractory nephrotic syndrome were enrolled. Each group received intravenous injection of cyclophosphamide (CTX) at a dose of 12 mg / kg and intravenous infusion of 250 ml of 10% glucose solution once every 3 to 4 weeks for 8 to 10 days Times, changed to once every 3 months, to maintain six months to 1 year to ease the withdrawal. Cumulative volume of 120 ~ 150mg / kg, CTX shock combined with the application of prednisone routine treatment. Results After shock treatment, the levels of total protein and albumin in plasma increased to some extent. The quantitative urinary protein in 24 hours decreased significantly, and there was a significant difference between before and after shock treatment (P <0-01). Serum creatinine (SCr) and endogenous creatinine clearance (CCr) shock treatment before and after no significant difference (P> 0-05). As the number of shocks increased, the number of complete and partial remissions increased. Conclusion cyclophosphamide impact therapy can be refractory to nephropathy may have a good effect, especially for children with frequent recurrence and hormone dependence treatment effect.