目的：探讨大剂量环磷酰胺（CTX）联合强的松治疗肾病综合征型紫癜性肾炎患儿的疗效。方法肾病综合征型 HSPN 患儿42例，按随机数字表法随机分为治疗组（23例）和对照组（19例），治疗组采用口服强的松片联合大剂量 CTX 冲击治疗，对照组仅口服强的松片治疗，评价 CTX 冲击治疗的效果。结果治疗组患儿的完全缓解率为65．2％，总体缓解率为95．7％，对照组患儿的完全缓解率为15．8％，总体缓解率为68．4％，治疗组完全缓解率及总体缓解率高于对照组，差异有统计学意义（P ＜0．05）；通过14 w 的治疗，两组的24 h 尿蛋白、血尿素氮（BUN）、血肌酐（Scr）、总胆固醇（TC）和甘油三酯（TG）的水平均有不同程度下降，治疗组明显优于对照组（P ＜0．05）；血浆白蛋白（ABL）水平均有不同程度上升，治疗组优于对照组（P ＜0．05）；治疗组患儿的不良反应发生率亦明显低于对照组（P ＜0．05）。结论环磷酰胺冲击治疗儿童肾病综合征型紫癜性肾炎较单独采用强的松片口服效果好，且不良反应较少。%Objective To investigate the effect of cyclophosphamide (CTX)and prednisone combination therapy on children with nephritic syndrome purpuric nephritis (NSPN).Methods The NSPN patients were randomly divided into treatment group and control group.The treatment group was adopted oral prednisone tablets combined with high-dose CTX therapy while the control group was only adopted oral prednisone tablets to further evaluate the effect of CTX on the treatment of shock.Results The complete remission rate of the treatment group and the control group were 65.2% and 15.8% respectively,and the overall response rate of the treatment group and the control group were 95.7% and 68.4% respectively, which there were significant difference between the two groups (P < 0.05,P <0.01).After 12 weeks, 24 h urinary protein,blood urea nitrogen (BUN),serum creatinine (Scr),total cholesterol (TC)and tri-glyceride (TG)levels of the two groups were decreased,and albumin (ABL)levels were increased to vari-ous degrees,moreover based on those data,the experimental group indicated significantly better than the control group (P <0.05),the adverse reaction in the treatment group was obviously lower than that of the control group (P <0.05).Conclusion Cyclophosphamide plus prednisone therapy in treatment of NSPN children is relatively better than prednisone alone therapy,and less adverse reactions occurrence.
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