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目的：采用大剂量环磷酰胺冲击疗法治疗３５例儿童难治性肾病，对其疗效和副作用进行观察方法：环磷酰胺每次６５０～９５０ｍｇ／ｍ２，每月静脉注射１次，共１０～１２次，总剂量不超过３００ｍｇ／ｋｇ，结合强的松０．５～１ｍｇｋｇ－１ｄ－１维持量治疗。结果：除２例放弃治疗外，余３３例肾病中临床完全缓解达８７．９％（２９／３３），尤其对微小病变及系膜增殖性肾小球肾炎疗效显著，局灶节段性肾炎有较好疗效。随访１３～２７月，平均２０月，两例复发（２／３３）占６．７％。副作用有轻度外周血白细胞计数偏低，恶心呕吐，脱发等，肝肾功能治疗前后无变化。结论：大剂量环磷酰胺冲击疗法治疗儿童难治性肾病，具有提高其缓解率，减少和推迟复发等优点，虽有一定的副作用，但在临床仔细监护下仍是一种较为有效和安全的疗法
OBJECTIVE: To treat 35 children with refractory nephropathy by high-dose cyclophosphamide shock therapy, and to observe the curative effect and side effect of cyclophosphamide: 650 ~ 950mg / m2 cyclophosphamide once a month for 10 ~ 12 Times, the total dose does not exceed 300mg / kg, combined with prednisone 0.5 ~ 1mgkg-1d-1 maintenance dose. Results: In addition to giving up treatment in 2 cases, the clinical complete relief of the remaining 33 cases of nephropathy reached 87.9% (29/33), especially for minimal change and mesangial proliferative glomerulonephritis, focal segmental nephritis Have a good effect. Follow-up from 13 to 27 months, an average of 20 months, two cases of recurrence (2/33) accounted for 6.7%. Side effects of mild peripheral blood leukocyte count is low, nausea and vomiting, hair loss, liver and kidney function before and after treatment did not change. Conclusion: The high dose of cyclophosphamide shock therapy in children with refractory nephropathy has the advantages of improving its remission rate, reducing and postponing relapse, etc. Although it has certain side effects, it is still a more effective and safe under the careful clinical monitoring therapy