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prednisolone

肿瘤

关键词肿瘤 疾病 强的松龙

词汇介绍

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解析

Prednisolone   /prɛd'nɪsə,lon/

       n. 脱氢皮质醇,泼尼松龙(一种糖皮质激素)

       The combination of prednisolone and azathioprine has only a minor effect, whereas the addition of ciclosporin attenuates protective antibody responses to influenza vaccination. 泼尼松龙和硫唑嘌呤联合应用的影响较小,而加用环孢素则减弱了针对流行性感冒接种的保护性抗体应答。

概述

泼尼松龙,分子式C21H28O5,又称氢化泼尼松,氯泼尼松,强的松龙,去氢氢化可的松,百力特,醋酸泼尼松龙,醋酸酯为白色或几乎白色结晶性粉末,无臭,味苦。几乎不溶于水,微溶于乙醇或氯仿。属肾上腺糖皮质激素及促皮质激素用药,为中效糖皮质激素。其疗效与泼尼松相当,其抗炎作用更强,水盐代谢作用很弱。本品为羟基化合物(羟基在11位上),局部应用疗效较好,如皮肤病和眼病,因其在局部直接有效,也适用于肝功能不全患者。口服吸收快而完全,1小时达血药浓度峰值,血浆蛋白结合率为90%~95%,半衰期约200分

Long term tapering versus standard prednisolone treatment for first episode of childhood nephrotic syndrome: phase III randomised controlled trial and economic evaluation复制标题

长期减量与标准泼尼松龙治疗儿童肾病综合征首发: III期随机对照试验和经济学评价

发表时间:2019-05-23

影响因子:27.6

作者: Nicholas J A Webb

期刊:BMJ

The best initial prednisolone regimen for children presenting with steroid sensitive nephrotic syndrome remains unknown. The eight week course first described in the 1960s by the International Study of Kidney Disease in Children (prednisolone 60 mg/m2 for four weeks then 40 mg/m2 on alternate days for four weeks) continues to be used in most UK centres and in many other countries. However, systematic review data suggest that a more intensive initial treatment course improves clinical outcomes. When the prednisolone in nephrotic syndrome (PREDNOS) trial started, six randomised controlled trials had compared the eight week course with a range of different prednisolone regimens of three months or longer. A 2005 Cochrane review concluded that prednisolone treatment of three months or longer statistically significantly reduced the rate of relapse at 12-24 months and the rate of frequently relapsing nephrotic syndrome. The Kidney Disease: Improving Global Outcomes guidelines published in 2012 supported the conclusions of this Cochrane review. These guidelines recommended daily prednisolone treatment of 60 mg/m2 or 2 mg/kg for four to six weeks followed by 40 mg/m2 or 1.5 mg/kg on alternate days and continued for two to five months, with tapering of the dose.

译文

对于出现类固醇敏感性肾病综合征的儿童,最好的初始泼尼松龙治疗方案仍然未知。 20世纪60年代首次在儿童肾病研究中描述的八周疗程(泼尼松龙60 mg / m2,持续4周,然后隔天40 mg / m2,持续4周)继续用于大多数英国中心和许多其他国家。然而,系统评价数据表明,更密集的初始治疗过程可改善临床结果。当肾病综合征(PREDNOS)试验中的泼尼松龙开始时,六项随机对照试验将8周疗程与一系列不同泼尼松龙方案进行了三个月或更长时间的比较。 2005年Cochrane评价得出结论,泼尼松龙治疗3个月或更长时间在统计学上显着降低了12-24个月的复发率和频繁复发的肾病综合征的发生率。 2012年发表的“肾病:改善全球预后指南”支持了该Cochrane评价的结论。这些指南推荐每日泼尼松龙治疗60 mg / m2或2 mg / kg,持续4至6周,然后隔日接受40 mg / m2或1.5 mg / kg,持续2至5个月,逐渐减少剂量。