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目的 观察环磷酰胺静脉冲击 (IV CTX)治疗重症紫癜性肾炎 (HSN)的近期疗效。方法 对临床和病理确诊为HSN ,表现为急性肾炎综合征型和 /或肾病综合征型 ,肾小球有袢坏死或新月体形成的 8例患儿进行IV CTX治疗 ,CTX剂量按 0 5～ 0 75 g/ (m2 ·次 ) ,每月 1次 ,总疗程 1 2次 ,累积剂量 <2 5 0mg/kg ,治疗开始时联合使用强的松 ,随访 5～ 32个月。 结果 8例尿蛋白转阴 ,肉眼血尿消失 ,其中 1例转为镜下血尿 ,镜检尿红细胞数个～ +/HP ,2例血肌酐明显高于正常者治疗后降至正常。结论 IV CTX治疗重症HSN的近期疗效令人满意 ,远期疗效有待进一步临床验证。
Objective To observe the short-term effect of intravenous cyclophosphamide (IV CTX) in the treatment of severe purpura nephritis (HSN). Methods Eight patients with HSN diagnosed clinically and pathologically as acute nephritic syndrome and / or nephrotic syndrome, glomerular necrosis or crescent formation were treated with CTX CTX at a dose of 0 5 ~ 0 75 g / (m2 · times) once a month for a total of 12 courses of treatment, with a cumulative dose of 250 mg / kg. Prednisone was used at the beginning of the treatment and was followed up for 5 to 32 months. Results Urinary protein in 8 cases turned negative and gross hematuria disappeared. One case turned to microscopic hematuria and the number of urinary erythrocytes was ~ + / HP. Serum creatinine in 2 cases was significantly lower than that in normal controls. Conclusion The short-term curative effect of IV CTX in the treatment of severe HSN is satisfactory. The long-term curative effect needs further clinical verification.