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題名 | Levamisole in Steroid-sensitive Nephrotic Syndrome Children with Steroid-dependency and/or Frequent Relapses=Levamisole用於經常復發及/或類固醇依賴型原發性腎症候群兒童之經驗 |
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作者 | 傅令嫻; 遲景上; Fu, Lin-shien; Chi, Ching-shiang; |
期刊 | 臺灣兒科醫學會雜誌 |
出版日期 | 20000300、20000400 |
卷期 | 41:2 民89.03-04 |
頁次 | 頁80-84+112 |
分類號 | 417.574 |
語文 | eng |
關鍵詞 | 原發性腎病症候群; 經常復發者; 類固醇依賴型; Levamisole; Steroid-sensitive nephrotic syndrome; Frequent relapser; Steroid-dependency; |
中文摘要 | 自1996年10月至1998年12月,我們以前瞻性方式,蒐集27例經常複發者及/或類固醇依賴型原發性腎病症候群兒童作爲研究對象。其中包括18位經常及9位類固醇依賴型安全。依病童反應,於每日或隔一日投予Levamisole2至3毫克/公觔。並定期追蹤其尿蛋白,血液白血球,及肝,腎功能。經6至26個月追蹤結果顯示:腎病症候群發作頻率降低由每年5.74±3.24降至1.91±2.0次,(p<0.05);且平均口服類固醇劑量亦由每日每公觔0.62±0.42降至0.21±0.35毫克(p<0.05)。對於Levamisole之反應與腎病症候群開始發作年齡,先前口服類固醇劑量,是否用過化學制劑,或腎臓病理變化皆無關。最駐要副作用爲暫時性球低下,曾有4位(15%)病童發生過。幫我們認爲Levamisole用於經常複發者及/或類固醇依賴型原發性腎症症候群兒童,安全且有效,四分之三會有反應,值得應用。 |
英文摘要 | The study is to evaluate the effect of levamisole on steroid-sensitive nephrotic syndrome (SSNS) children with multiple relapses, from October 1996 through December 1998, we prospectively recruited 27 SSNS children. Eight children had minimal change nephrotic syndrome and nine had mesangial nephropathy proven by renal biopsy. The other 10 children had normal renal function and no secondary cause of nephrotic syndrome (NS). Nine were frequent relapsers (FR), (>4 attack per year), nine were steroid- dependent (SD), and another nine were both FR and SD. The dosage of levamisole given was 2 to 3 mg/kg daily or every other day, depending on the patients’ response. All were followed regularly at outpatient department. Follow-up items included a routine urinalysis every month, complete blood count (CBC) every 3 months and BUN/Cr, AST/ALT every 6 months. After 6 to 24 (mean 12.2) months of follow-up, the frequency of relapse (FoR) decreased (5.74±3.24 vs 1.91±2.0/ year p<0.05). Seven (26%) had no relapse at all. Nine (33.3%) had less than 1/3 the FoR; four (14.8%) had 1/3 to 1/2 the FoR; and seven (26%) still had more than 1/2 FoR as before levamisole. The oral prednisolone dosage also decreased (0.62±0.42 vs 0.21±0.35mg/kg/day, p<0.05). The levamisole response was independent of the age of NS onset, the interval between NS onset and initiation of levamisole, previous number of relapse, the FoR, and previous use of cytotoxic drug. There were 7 episodes of leukopenia, which returned to normal after discontinuing levamisole Jbr I to 2 weeks in 4 patients. Two (7.5%) had reversible leukopenia for more than 4 weeks. No abnormal BUN/Cr, or ALT/AST levels were noted during folllow-up. Levamisole is an effective and safe drug for children who have SSNS with FR and/or SD. Two thirds of patients obtain satisfactory control. The dosage can be 2 to 3 mg/kg daily or every other day. The most common side effect is transient leukopenia. |
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