糖皮质激素和环磷酰胺治疗IgA肾病疗效及相关因素分析  

The efficacy of corticosteroids and cyclophosphamide treatment on IgA nephropathy

作　　者：方静[1] 卓莉[1] 李文歌[1] 邹古明[1] 芦建华[1] 曹娅丽[1] 

机构地区：[1]卫生部中日友好医院肾内科,北京100029

出　　处：《国际泌尿系统杂志》2012年第4期451-454,共4页International Journal of Urology and Nephrology

摘　　要：目的分析糖皮质激素和环磷酰胺治疗IgA肾病患者的疗效，寻找与疗效相关的临床和病理指标。方法217例IgA。肾病患者（尿蛋白定量≥1．0g／d，且Scr〈250μmol/L），应用糖皮质激素和环磷酰胺治疗1年后，对比分析治疗有效组和无效组临床及病理资料。将尿蛋白定量〈0．5g／d，或eGFR上升〉15％视为治疗有效。结果糖皮质激素和环磷酰胺治疗IgA。肾病有效者占82．49％，疗效与年龄、肾功能水平、尿蛋白、尿渗透压、肾小管萎缩和肾间质纤维化以及肾小球缺血硬化程度等有关。结论糖皮质激素和环磷酰胺是治疗IgA肾病有效方法，但选择该方案时，应考虑患者的临床和病理特点。Objectives Analysis the potential of corticosteroids and cyclophosphamide therapy on patients with IgA nephropathy （ IgAN）, to find the clinical and pathological features possible to derive information about likely response to treatment. Methods 217 patients with IgAN [ proteiuuria ≥ 1 g/d and serum creatinine （Scr） 〈 250μmol/L] one year followed - up from time of corticosteroids and cyclophosphamide therapy were divided into improved group （ proteinuria 〈 0.5g/d or eGFR modify 〉 15% ） and irreversible group, analysis the clinical and pathological features. Results With 82.49% therapeutic efficacy, age, renal function, uria osmotic pressure, glomerulosclerosis and tubulointerstitial scarring were correlative to the efficiency of corticosteroids and cyclophosphamide therapy. Conclusions The corticosteroids and cyclophosphamide therapy is effective for IgAN patients, however, choosing the therapy depend on clinical and pathological markers.

关 键 词：肾小球肾炎 IGA 糖皮质激素 环磷酰胺 

分 类 号：R692.31[医药卫生—泌尿科学]