临床医学
臨床醫學
림상의학
CLINICAL MEDICINE
2014年
9期
32-34
,共3页
环磷酰胺%霉酚酸酯%小儿难治性肾病综合征%疗效比较
環燐酰胺%黴酚痠酯%小兒難治性腎病綜閤徵%療效比較
배린선알%매분산지%소인난치성신병종합정%료효비교
Cyclophosphamide%Mycophenolate%Children with refractory nephrotic syndrome%Efficacy comparison
目的:比较环磷酰胺( CTX)与霉酚酸酯( MMF)治疗小儿难治性肾病综合征( RNS)的临床疗效。方法收集2004年1月至2009年1月济南军区第一五九中心医院儿科收治的小儿RNS的临床资料。按照用药将患者分为CTX组和MMF组,比较两组患儿缓解率、尿蛋白转阴时间、肾功能变化、3年内复发和不良反应发生情况。结果研究最终纳入47例,CTX组21例,MMF组26例,两组性别、年龄、病程比较差异无统计学意义。治疗结束时CTX组和MMF组的完全缓解率分别为28.57%和42.31%,差异无统计学意义(χ2=0.949,P=0.330),且两组缓解情况分布差异无统计学意义(Z=-0.538,P=0.590)。两组肾功能指标均有好转(P均﹤0.05),但MMF组24 h尿蛋白、白蛋白、血肌酐水平优于CTX组(P均﹤0.05)。MMF组尿蛋白转阴时间为(23.9±12.36)d,CTX组为(73.67±40.33)d,差异有统计学意义(P=0.002)。治疗结束3年内,CTX组复发8例,MMF组6例,差异无统计学意义(χ2=1.253,P=0.263)。治疗过程中两组均发生不良反应,多为食欲不振、恶心、呕吐,未发生严重不良反应。结论小样本临床研究中,在小儿RNS的尿蛋白转阴时间、改善肾功能方面MMF优于CTX,但两者均有较好的缓解作用,且完全缓解率、复发率、不良反应发生情况差异无统计学意义。
目的:比較環燐酰胺( CTX)與黴酚痠酯( MMF)治療小兒難治性腎病綜閤徵( RNS)的臨床療效。方法收集2004年1月至2009年1月濟南軍區第一五九中心醫院兒科收治的小兒RNS的臨床資料。按照用藥將患者分為CTX組和MMF組,比較兩組患兒緩解率、尿蛋白轉陰時間、腎功能變化、3年內複髮和不良反應髮生情況。結果研究最終納入47例,CTX組21例,MMF組26例,兩組性彆、年齡、病程比較差異無統計學意義。治療結束時CTX組和MMF組的完全緩解率分彆為28.57%和42.31%,差異無統計學意義(χ2=0.949,P=0.330),且兩組緩解情況分佈差異無統計學意義(Z=-0.538,P=0.590)。兩組腎功能指標均有好轉(P均﹤0.05),但MMF組24 h尿蛋白、白蛋白、血肌酐水平優于CTX組(P均﹤0.05)。MMF組尿蛋白轉陰時間為(23.9±12.36)d,CTX組為(73.67±40.33)d,差異有統計學意義(P=0.002)。治療結束3年內,CTX組複髮8例,MMF組6例,差異無統計學意義(χ2=1.253,P=0.263)。治療過程中兩組均髮生不良反應,多為食欲不振、噁心、嘔吐,未髮生嚴重不良反應。結論小樣本臨床研究中,在小兒RNS的尿蛋白轉陰時間、改善腎功能方麵MMF優于CTX,但兩者均有較好的緩解作用,且完全緩解率、複髮率、不良反應髮生情況差異無統計學意義。
목적:비교배린선알( CTX)여매분산지( MMF)치료소인난치성신병종합정( RNS)적림상료효。방법수집2004년1월지2009년1월제남군구제일오구중심의원인과수치적소인RNS적림상자료。안조용약장환자분위CTX조화MMF조,비교량조환인완해솔、뇨단백전음시간、신공능변화、3년내복발화불량반응발생정황。결과연구최종납입47례,CTX조21례,MMF조26례,량조성별、년령、병정비교차이무통계학의의。치료결속시CTX조화MMF조적완전완해솔분별위28.57%화42.31%,차이무통계학의의(χ2=0.949,P=0.330),차량조완해정황분포차이무통계학의의(Z=-0.538,P=0.590)。량조신공능지표균유호전(P균﹤0.05),단MMF조24 h뇨단백、백단백、혈기항수평우우CTX조(P균﹤0.05)。MMF조뇨단백전음시간위(23.9±12.36)d,CTX조위(73.67±40.33)d,차이유통계학의의(P=0.002)。치료결속3년내,CTX조복발8례,MMF조6례,차이무통계학의의(χ2=1.253,P=0.263)。치료과정중량조균발생불량반응,다위식욕불진、악심、구토,미발생엄중불량반응。결론소양본림상연구중,재소인RNS적뇨단백전음시간、개선신공능방면MMF우우CTX,단량자균유교호적완해작용,차완전완해솔、복발솔、불량반응발생정황차이무통계학의의。
Objective To compare the clinical effects of CTX and MMF on children with refractory nephrotic syndrome (RNS). Methods The clinical data of children with RNS admitted in the 159th central hospital of Jinan military region from January 2004 to January 2009 were collected. According to different medications,the patients were divided into the CTX group and MMF group. The remission rate,urine protein clearance time,renal function changes,recurrence within 3 years and adverse reactions were compared between the two groups. Results The study ultimately included 47 cases,with 21 cases in CTX group and 26 cases in MMF group. There were no significant differences in the gender,age,disease duration between the two groups. The complete remission rate in the MMF group and CTX group at the end of treatment was 28. 57% and 42. 31% respectively, but the difference was not significant(χ2 =0. 949,P=0. 330). And the overall remission of the two groups has no significant difference(Z= -0. 538,P=0. 590). After treatment,the indicators of kidney function improved compared with those before treatment(P﹤0. 05). But the levels of 24 h urine protein,Alb,Scr of the MMF group were superior to those of the CTX group (P﹤0. 05). The urine protein clearance time was(23. 9 ± 12. 36)days in the MMF group,and(73. 67 ± 40. 33)days in the CTX group,the difference was significant( P=0. 002). During the 3 years after the treatment,8 patients in CTX group relapsed, and 6 patients in MMF group relapsed,the difference was not significant(χ2 = 1. 253,P=0. 263). During the treatment,both groups showed adverse reactions,and the main adverse reactions were anorexia,nausea and vomiting,but there were no serious adverse reactions. Conclusion In the small sample clinical study,MMF is superior to CTX in the urine protein clearance time, improving the renal function of children with RNS,but both of MMF and CTX can alleviate the disease,and the complete remis-sion rates,recurrence rates and incidences of adverse reactions are the same.