关键词: 乙型肝炎病毒相关性肾炎, 儿童, 肝功能, 肾功能

Abstract: Objective To study the value of cyclophosphamide and cyclophosphamide + hormone in the treatment of pediatric hepatitis B virus-associated glomerulonephritis (HBV-GN).Methods Eighty-two cases of children with HBV-GN admitted to our hospital from July 2017 to July 2019 were randomly selected as research objects. After admission, the children were divided into group A (n=41) and group B (n=41) according to different medication methods. Group B was treated with cyclophosphamide tablets, and group A was treated with hormone and cyclophosphamide tablets. The clinical therapeutic effect of the 2 groups was evaluated after 6 months of administration, and the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glomerular filtration rate (GFR) and albumin (ALB) were compared before and after treatment. Besides, the incidence of adverse reactions during administration was calculated. Results The total effective rate of group A was significantly higher than that of group B (80.49% vs 58.54%, P<0.05). The ALT and AST levels 3 and 6 months after treatment of group A [(49.21 ± 8.02) U/L, (72.23 ± 8.02) U/L, (35.43 ± 5.11) U/L, (42.30 ± 4.12) U/L)] were significantly lower than those before treatment [(74.53 ± 12.43) U/L, (82.74 ± 10.25) U/L], and those of group B [(54.72 ± 8.45) U/L, (77.21 ± 8.54) U/L, (42.56 ± 5.58) U/L, (48.53 ± 5.83) U/L), P<0.05]. The GFR and ALB levels of group A 3 and 6 months after treatment [(69.42 ± 13.66) mL/min, (28.54 ± 7.21) g/L, (84.22 ± 15.54) mL/min, (33.52 ± 8.06) g/L] were significantly lower than those before treatment [(58.21 ± 10.53) mL/min, (20.35 ± 5.13) g/L], and those of group B [(63.25 ± 12.53) mL/min, (24.53 ± 6.18) g/L, (75.58 ± 14.85) mL/min, (29.54 ± 7.25) g/L, P<0.05]. There was no significant difference in the incidence of adverse reactions (17.07% vs 9.76%) between the 2 groups (P>0.05).Conclusion Compared with cyclophosphamide alone, the combination of cyclophosphamide and hormone in the treatment of children with HBV-GN can improve their liver and kidney function better, with significant clinical efficacy and good safety.

Key words: Hepatitis B virus-associated glomerulonephritis, Children, Liver function, Renal function