Imbasciati E, Gusmano R, Edefonti A, Zucchelli P, Pozzi C, Grassi C, Della Volpe M, Perfumo F, Petrone P, Picca M
Br Med J (Clin Res Ed). 1985 Nov 9;291(6505):1305-8. doi: 10.1136/bmj.291.6505.1305.
In a multicentre, randomised, prospective trial 89 patients (67 children and 22 adults) with the minimal change nephrotic syndrome were treated with three intravenous pulses of methylprednisolone followed by low dose oral prednisone for six months (group given methylprednisolone) or with high dose oral prednisone for four weeks followed by low dose oral prednisone for five months (control group). Five patients in the group given methylprednisolone and one in the control group did not respond initially. The time to response was shorter in children treated with methylprednisolone. No significant differences between the two groups were observed in the number of patients who relapsed or number of relapses per patient per year. Patients given methylprednisolone tended to relapse earlier than patients in the control group. Side effects related to treatment were significantly fewer in the group given methylprednisolone than in the control group. These data suggest that a short course of methylprednisolone pulses followed by low dose oral prednisone is only marginally less effective than a regimen of high dose oral steroids but can improve the ratio of risk to benefit associated with treatment of the minimal change nephrotic syndrome.
在一项多中心、随机、前瞻性试验中，89例微小病变肾病综合征患者（67例儿童和22例成人）接受了三次静脉注射甲泼尼龙脉冲治疗，随后口服低剂量泼尼松六个月（甲泼尼龙组），或口服高剂量泼尼松四周，随后口服低剂量泼尼松五个月（对照组）。甲泼尼龙组有5例患者，对照组有1例患者最初无反应。接受甲泼尼龙治疗的儿童反应时间较短。两组在复发患者数量或每位患者每年的复发次数方面未观察到显著差异。接受甲泼尼龙治疗的患者往往比对照组患者更早复发。甲泼尼龙组与治疗相关的副作用明显少于对照组。这些数据表明，短疗程甲泼尼龙脉冲治疗后口服低剂量泼尼松，其疗效仅略低于高剂量口服类固醇方案，但可改善微小病变肾病综合征治疗的风险效益比。
