Clinical evaluation of cyclosporine A or cyclophosphamide combined glucocorticoid in the treatment of infantile nephrotic syndrome

Objective To observe the clinical effect of cyclosporine A(CsA) or cyclophosphamide(CTX) combined glucocorticoid in the treatment of infantile nephrotic syndrome.Methods Fifty-one cases of infantile nephrotic syndrone were selected and divided into CsA group(n = 35) and CTX group(n = 16).On the basis of oral prednisone,the patients were given oral CsA 3 ～ 5 mg /(kg·d) in CsA group,and intravenous CTX 10 mg /(kg·d) in CTX group.The total treatment course were 6 months.Before treatment,3 and 6 months after treatment,indicators of changes in urine routine,24 h urinary protein excretion,liver function,renal function(serum creatinine and blood urea nitrogen),plasma cholesterol,plasma albumin,and recorded adverse reactions were recorded.Results After 3 ～ 6 months,the total effective rate in CsA group was 83%,89%,and 75%,81% in cyclophosphamide group.There was no statistically significant between two groups(P 0.05).And the biochemical indicators in two groups were improved than before treatment(P 0.01).After 3 ～ 6 months,urinary protein in CTX group was lower than that in CsA group,and serum albumin was higher than that in cyclosporine group(P 0.01);while serum creatinine after 3 months and blood urea nitrogen after 6 months in CsA group less than those in CTX group(P 0.01).Adverse reactions in both groups showed no significant difference(P 0.05),in which children were more of facial hirsutism in CsA group,and more gastrointestinal reactions in CTX group(P 0.01).Conclusions For infants and young children with nephrotic syndrome,CsA or CTX combined hormone therapy could achieve good effect,the former could be better to improve renal function,and the latter could be better to improve proteinuria and hypoproteinemia.It should be based on the individual clinical situation of every patient to select the appropriate treatment.