环孢素A、强的松和抗凝联合治疗特发性膜性肾炎的回顾性分析  

A RETROSPECTIVE ANALYSIS ON CYCLOSPORINE A, PREDNISONE AND ANTICOAGULATIVE THERAPY IN PATIENTS WITH IDIOPATHIC MEMBRANOUS NEPHRITIS

作　　者：竺艳娟[1] 廖履坦[1] 吴兆龙[1] 陶凤武[1] 

机构地区：[1]上海医科大学中山医院肾病科

出　　处：《上海医科大学学报》1998年第6期460-462,共3页Journal of Fudan University(Medical Science)

摘　　要：比较单用强的松、强的松＋环磷酰胺、强的松＋环孢素Ａ３种不同方法治疗特发性膜性肾炎的疗效，进行３～１０ａ的随访总结。方法测定患者的２４ｈ尿蛋白定量及血清肌酐值以评定治疗效果。结果单用强的松治疗组３０例，完全缓解１１例（３７％），部分缓解７例（２３％），有效率６０％；强的松＋环磷酰胺组２４例，完全缓解１０例（４２％），部分缓解４例（１６％），有效率５８．３％；强的松＋环孢素Ａ组２６例，完全缓解１９例（７３％），部分缓解４例（１５％），有效率８８．５％。在随访中，３组患者的两年复发率分别为３３．３％，３５．７％，３４．８％，其差别无显著性。结论建议在特发性膜性肾炎的治疗上，对激素无效者可加用环孢素Ａ治疗以提高疗效。PURPOSE To compare the efficacy of cyclosporine A with prednisone alone, cyclophosphamide plus prednisone in patients with idiopathic membranous nephritis, and to observe the recurrence during 3～10 years follow up. METHODS The quantity of 24h protienuria, serum creatine value were investigated in 80 patients. RESULTS In the prednisone alone group of 30 cases, a complete remission of protienuria (CR) was in 11 and a partial remission (PR) in 7, the remission rate was 60%. In the cyclophosphamide plus prednisone group of 24 patients, CR was in 10 and PR in 4 with the remission rate 58.3%. In the cyclosporine A group of 26 cases, CR 19, PR 4, and the remission rate was 88.5%. There was no significant difference in 2-years recurrent rates of all the three groups. CONCLUSIONS It is suggested that cyclosporine A should be given in patients with idiopathic membranous nephritis, who showed no response to corticosteriod therapy.

关 键 词：肾炎 特发性 膜性肾炎 环孢素A 强的松 抗凝疗法 

分 类 号：R692.390.5[医药卫生—泌尿科学]