Broyer M, Tete M J
Service de Néphrologie Pédiatrique, Hôpital des Enfants-Malades, Paris.
Ann Pediatr (Paris). 1990 Feb;37(2):91-3.
Eighteen pediatric patients with cystinosis were treated with cysteamine. Treatment was started at a variable age, between 10 months and 7 years, and was continued for 6 months to eight years. Results were evaluated on renal function changes and growth. Whereas 65% of patients with cystinosis develop terminal renal failure before the age of ten years, three (16%) of our 18 patients given cysteamine started dialysis before the age of ten and all three had first received cysteamine only after 4 1/2 years of age. The plasma creatinine level was also lower in treated patients as compared with a control multicenter group. Growth was also significantly improved by treatment, especially in those children treated before the age of 26 months who were taller by 2 SD at age five and 2.5 SD at age eight than untreated controls. Some children who complied strictly with the treatment regimen had an normal stature (- 1 SD) at ten years of age. In conclusion, the effectiveness of cysteamine seems obvious in this group of patients if rigorous compliance with the drug dosing schedule is achieved.
18名患有胱氨酸病的儿科患者接受了半胱胺治疗。治疗开始的年龄各不相同,在10个月至7岁之间,持续时间为6个月至8年。根据肾功能变化和生长情况对结果进行评估。虽然65%的胱氨酸病患者在10岁前会发展为终末期肾衰竭,但我们18名接受半胱胺治疗的患者中有3名(16%)在10岁前开始透析,且这3名患者均在4岁半之后才首次接受半胱胺治疗。与对照多中心组相比,接受治疗的患者血浆肌酐水平也较低。治疗也显著改善了生长情况,尤其是那些在26个月龄前接受治疗的儿童,他们在5岁时比未治疗的对照组高2个标准差,在8岁时高2.5个标准差。一些严格遵守治疗方案的儿童在10岁时身高处于正常水平(-1个标准差)。总之,如果严格遵守药物给药时间表,半胱胺在这组患者中的有效性似乎是显而易见的。