Tsao Y C, Yeung C H
Arch Dis Child. 1971 Jun;46(247):327-31. doi: 10.1136/adc.46.247.327.
Cyclophosphamide and prednisone were compared as the primary treatment for the nephrotic syndrome in 27 boys and 4 girls. The patients, aged between 2½ and 11, were paired according to their renal histology; 19 belonged to the type, 8 to the type, and 4 had but with selective type of proteinuria. The two groups of patients were comparable as regards period of observation before treatment, and duration of follow-up. About half the patients of each group went into spontaneous diuresis, or had no fluid retention, before treatment was started. Cyclophosphamide induced a remission more slowly than prednisone, but remission was less likely to be followed by relapse. Two patients treated with prednisone and one treated with cyclophosphamide still had persistent proteinuria at the time of review. The incidence of cyclophosphamide resistance in nephrosis remains unknown, but is probably not high. Among patients who responded to treatment, duration of persisting proteinuria varied widely, and therefore slow response must be distinguished from true resistance to treatment. Cyclophosphamide should be useful in all patients who relapse after a steroid-induced remission, but its use must be balanced against potential long-term hazards.
对27名男孩和4名女孩的肾病综合征进行了环磷酰胺和泼尼松作为主要治疗方法的比较。这些患者年龄在2岁半至11岁之间，根据肾脏组织学进行配对；19例属于某型，8例属于另一型，4例有某情况但为选择性蛋白尿型。两组患者在治疗前的观察期和随访时间方面具有可比性。每组约一半的患者在开始治疗前出现自发性利尿或无液体潴留。环磷酰胺诱导缓解比泼尼松慢，但缓解后复发的可能性较小。在复查时，2例接受泼尼松治疗的患者和1例接受环磷酰胺治疗的患者仍有持续性蛋白尿。肾病中环磷酰胺耐药的发生率尚不清楚，但可能不高。在对治疗有反应的患者中，持续性蛋白尿的持续时间差异很大，因此必须将反应缓慢与真正的治疗抵抗区分开来。环磷酰胺对所有在类固醇诱导缓解后复发的患者都应有用，但其使用必须与潜在的长期危害相权衡。
