| Background: Nephrotic syndrome is a kind of common glomerulonephritis in children. The morbility is increase all over world. Nowadays the corticoid is still the first considered drug.But there are three kinds of NS that are difficult to treat.They are steroid-resistant nephrotic syndrome (SRNS), steroid-dependent nephrotic syndrome (SDNS) and frequent relapse(FR),called refractory nephrotic syndrome. For this reason, the effect is not satisfied or the course of treatment is long, accompaning with the side effects of uesing corticoid, such as growth inhibition, bone rarefaction and so on. Now it is lack of correlative studies.The objective of this study is to compare the effect of corticoid treatment associating CTX-PT with using only corticoid treatment, and contrast the frequency of relapses.The more important is to investigate the factors which influenced the effect of CTX-PT in this study and the safety of CTX-PT.Methods: CTX-PT (8-10 mg/kg, once every 2 weeks for 6-7 times,two days for every time) was given to 35 children with RNS (including 24 boys and 11 girls, aged from 2-year to 15-year, the average age was 6.63 years).The relevant data on clinical, pathological and laboratory tests were collected and analyzed.Results: 1.Twenty-eight cases (80%) got complete remission and seven cases (20%) got partial remission after CTX-PT, so the total effica of this therapy was 80%, and it took 6.06±3.58 (weeks). Without CTX-PT,it took 10.57±8.44(weeks) for twenty-six cases (74.3%) got complete remission and nine cases(25.7%) got partial remission.In children with the complete remission, half of them (57.1%) got the remission in the previous three treatment, most of them (82.1%) got the remission in the previous five treatment. 2. One case (2.86%) got frequent relapse in 6 months, and only this one case(2.86%) got frequent relapse in 1 year after CTX-PT. Three case (8.57%) got frequent relapse in 6 months, and thirteen cases (37.1%) got frequent relapse in 1 year without CTX-PT. 3. Nineteen cases (90.5%) in twenty-one of simple type NS got complete remission,and nine cases (64.3%) in fourteen of nephtitic type NS got complete remission.Four cases (100%) with MCN got complete remission,nine cases(56.3%) got complete remission. Eleven cases (61.1%) of SRNS SRNS,comparing with two cases (100%) of SDNS and fifteen (100%) of FR got complete remission.4.The Scr and excretions of urinary protein in the patients, the levels of IgG, IgA were the most important factors which influenced the effect of CTX-PT in this study. The Scr levels (μmol/L) in the complete remission group and partial remission group were (52.13±29.80) and (68.20±38.00)μmol/L.The excretions of urinary protein(g/24h): (1.79±2.38) and (4.66±3.42). The IgG levels (g/L): (3.95±2.37) and (1.87±0.67). The IgA levels (g/L): (1.58±0.92) and (1.26±0.71). The study showed that there was no relationship between the therapy and the sex, the levels of Alb, Ch, IgM and BUN (P>0.05). 5. Eleven cases (31.4%) were found to have side effects. Both vomiting and repeated infections occurred at 14.3%, and abnormal of liver functions occurred at 2.9%. Losing hairs, the decrease of blood platelet counts and decrease of white blood cells didn't occurred in our research. These side effects were transient and could remit spontaneously or after symptomatic treatment.Conclusion: 1.CTX-PT in children with RNS can shorten the time of therapy. 2. CTX-PT can reduce frequency of relapses. 3. The effects in children with SDNS and FR are better than the SRNS cases. The clinical types, the pathology type of this disease, have all no relationship with the effect of this therapy. 4. The levels of Scr, IgG, IgA and excretions of urinary protein of patients were important factors which influenced the efficacy of CTX-PT, the sex, the levels of Alb, Ch, IgM, BUN, have all no relationship with the effect of this therapy. 5. There are a few side effects of CTX-PT, but with confirmed safe.
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