环磷酰胺与吗替麦考酚酯治疗儿童频复发肾病综合征的疗效比较
Treatment of frequently relapsing idiopathic nephrotic syndrome in children: cyclophosphamide vs mycophenolate mofetil
回顾性分析环磷酰胺(CTX)、吗替麦考酚酯(MMF)治疗儿童频复发特发性肾病综合征(INS)43例临床资料,其中CTX组18例,MMF组25例.结果显示CTX组平均维持缓解6.0个月;平均复发频率由4.8次/年降至1.1次/年(P<0.001);平均激素用量由30.0 mg/d减至15.0 mg/d(P =0.002).MMF组平均维持缓解6.0个月;平均复发频率由用药前的4.8次/年降至1.6次/年(P<0.001);平均激素用量由37.5 mg/d减至12.5 mg/d(P<0.001).CTX组与MMF组用药后维持缓解时间、复发频率及激素用量比较差异无统计学意义(P>0.05).提示两药均可降低频复发INS患儿的复发频率;鉴于MMF服用方便,不良反应可能更小,选择用药时可优先考虑.
更多The clinical data of 43 children diagnosed as idiopathic nephrotic syndrome (INS) with frequent relapse and treated with cyclophosphamide (CTX) or mycophenolate mofetil (MMF) were retrospectively analyzed.In this series of patients 18 were treated with CTX and 25 were treated with MMF.After CTX therapy the relapse-free period was round 6.0 months,the relapse rate decreased from 4.8 episodes/y to 1.1 episodes/y(P <0.001)and prednisone dose was reduced from 30.0 mg/d to 15.0 mg/d (P =0.002).After MMF therapy the relapse-free period was also round 6.0 months,the relapse rate decreased from 4.8 episodes/y to 1.6 episodes/y(P <0.001)and the prednisone dose was reduced from 37.5 mg/d to 12.5 mg/d(P < 0.001).There were no significant differences in relapse-free period,relapse rate and reduction of prednisone dose (P > 0.05) between MMF and CTX groups.This retrospective study shows that both MMF and CTX are effective immunosuppressive agents for children with frequently relapsing INS,however,MMF is more convenient and safe to administrate,it may be proposed before CTX.
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