Cerkauskiene Rimante, Kaltenis Petras
Department of Pediatrics, Vilnius University Children's Hospital, Santariskiu 4, 08406 Vilnius, Lithuania.
Medicina (Kaunas). 2005;41 Suppl 1:26-30.
There are several reports in the literature indicating that fusidic acid owns functions similar to those of cyclosporin. As cyclosporin has effectively been used in frequently relapsing steroid-responsive nephrotic syndrome we carried out this study to determine whether fusidic acid used along with prednisolone diminishes rate of steroid-responsive nephrotic syndrome relapses in children.
The patients were randomly allocated to receive either prednisolone alone or prednisolone plus fusidic acid for two months in standard doses. In the cases of relapses the treatment was changed to the comparative treatment method. Altogether 18 children (12 boys and 6 girls) aged 1.3 to 13.2 years entered the study. Thirteen of them were treated by either method on different occasions, four patients were treated with prednisolone only, and one child was treated with prednisolone plus fusidic acid only. Thus, there were 17 evaluable treatment courses with prednisolone alone and 14 courses with prednisolone plus fusidic acid. The patients were followed-up as long as the remission lasted.
There was prompt and complete response under the influence of both treatment methods. However, relapses occurred in all the patients irrespective of the mode of treatment. Mean duration of remissions did not differ significantly between the study groups (17.8+/-20.4 weeks in the prednisolone group and 18.3+/-23.9 weeks in the prednisolone plus fusidic acid group; p>0.05). There were no statistically significant differences in laboratory parameters reflecting therapeutic efficacy in the comparative treatment groups, too.
Thus, it was not revealed any remission-sustaining efficacy of fusidic acid used in standard doses for two months along with prednisolone in children with frequently relapsing steroid-responsive nephrotic syndrome.
文献中有几篇报道表明夫西地酸具有与环孢素类似的功能。由于环孢素已有效地用于频繁复发的激素敏感性肾病综合征，我们开展了这项研究，以确定夫西地酸与泼尼松龙联合使用是否能降低儿童激素敏感性肾病综合征的复发率。
将患者随机分为两组，一组单独接受标准剂量的泼尼松龙治疗两个月，另一组接受泼尼松龙加夫西地酸治疗两个月。复发时，治疗方法改为对照治疗方法。共有18名年龄在1.3至13.2岁的儿童（12名男孩和6名女孩）进入该研究。其中13名儿童在不同时间接受了两种治疗方法中的一种，4名患者仅接受泼尼松龙治疗，1名儿童仅接受泼尼松龙加夫西地酸治疗。因此，单独使用泼尼松龙有17个可评估的治疗疗程，泼尼松龙加夫西地酸有14个疗程。对患者进行随访，直至缓解持续。
两种治疗方法均能迅速产生完全缓解。然而，无论治疗方式如何，所有患者均出现复发。研究组之间缓解的平均持续时间无显著差异（泼尼松龙组为17.8±20.4周，泼尼松龙加夫西地酸组为18.3±23.9周；p>0.05）。在反映对照治疗组治疗效果的实验室参数方面也没有统计学上的显著差异。
因此，对于频繁复发的激素敏感性肾病综合征儿童，未发现标准剂量的夫西地酸与泼尼松龙联合使用两个月有任何维持缓解的疗效。
