ALT Ma, ETL Soo, PC Tong, WM Lai, KC Tse, MC Chiu

Abstract

Steroid sensitive nephrotic syndrome (SSNS) is a common disease in childhood. Although most children respond to corticosteroid, relapse is a common problem. We aim to compare the effect of 2-month steroid treatment (standard course) according to International Study of Kidney Disease of Children (ISKDC) versus 6-month treatment (long course) on the clinical course of SSNS in a 1.5-year follow up in our centre. Medical records of patients seen from 1997-2006 were reviewed. A total of 46 patients were included in the study (standard course group=22, long course group=24). Patients treated with long course steroid had significantly lower relapse rate (33% versus 75%, p= 0.026) and higher percentage of sustained remission (p=0.0046) than that of standard course. None of our patients had significant growth retardation or hypertension. Therefore, 6-month corticosteroid may be preferable to the standard course for the initial treatment of SSNS in children.

類固醇敏感型腎病綜合徵（Steroid sensitive nephrotic syndrome, SSNS）是一種常見的兒童疾病。雖然大部分患兒對皮質激素治療有效，但復發是常見的問題。我們目的是通過在我們中心治療類固醇敏感型腎病綜合徵隨診1.5年的患兒中，對按國際兒童腎臟病研究（ ISKDC ）指引的2個月類固醇治療（標準療程）和6個月治療（長程治療）的效果作對比。對1997-2006年期間患者病歷進行了審查。共有46例患者納入研究（標準療程組=22 ，長期療程組=24 ）。相對標準療程，用長程類固醇治療的患兒有顯著較低復發率（75％比33％，p值=0.026 ）和較高持續緩解的百分比（ p值=0.0046 ）。沒有一個患者有顯著性發育遲緩或高血壓。因此，對類固醇敏感型腎病綜合徵的初始治療來說，6個月的皮質類固醇治療可能比標準療程更為適合。