环孢素联合糖皮质激素治疗IgA肾病的研究  

作　　者：杜红秀[1] 白寿军[1] 朱迎春[1] 查芳芳[1] 吴莲叶[1] 王青[1] 

机构地区：[1]复旦大学附属中山医院青浦分院,201700

出　　处：《浙江临床医学》2014年第6期878-880,共3页Zhejiang Clinical Medical Journal

摘　　要：目的观察环孢素联合糖皮质激素治疗以大量蛋白尿（蛋白尿≥3.5g/d）为主要表现的IgA肾病的临床效果。方法34例符合条件的IgA肾病患者随机入组环孢素联合激素治疗组（观察组，18例）和糖皮质激素治疗组（对照组，16例），记录并比较两组患者治疗6个月时的24h尿蛋白定量、血清白蛋白、血清肌酐及肾小球滤过率等指标，并观察两组患者的不良反应。结果两组患者治疗6个月时的24h尿蛋白定量较治疗前显著下降（P均〈0.05），血清白蛋白水平较治疗前显著升高（P均〈0.05），治疗前后血清肌酐水平及eGFR水平差异均无统计学意义，且两组间总有效率的差异无统计学意义（P=0.311）。两组均无因发生不良反应而退出研究者。结论环孢素联合糖皮质激素治疗以大量蛋白尿为主要表现的IgA肾病较单纯激素治疗起效快、疗效好，且不良反应少。Objective To observe the effect of ciclosporine combined with glucocorticoids in treatment of IgA nephropathy with severe proteinuria（≥3.5g/d）. Methods 34 cases meeting the conditions of IgA nephropathy patients were randomized into groups of ciclosporine combined glucocorticoid therapy group（test group,18 cases）and glucocorticoid treatment group（control group,16 cases）. The 24-hour urine protein,serum albumin,serum creatinine and glomerular filtration rate and other indicators of treatment were recorded and compared at 6 months.Adverse effects were recorded. Results Urine protein of the two groups were significantly decreased（P〈0.05）compared with pre-treatment after treatment of 6 months,and serum albumin levels were significantly higher than before treatment（P〈0.05）. Differences in serum creatinine and eGFR levels before and after treatment were not statistically significant（P〈0.05）. However,the total efficiency between the two groups was not statistically significant（P=0.311）.No patient withdrew from the study due to adverse effects. Conclusion Our findings may suggest that ciclosporine combined with glucocorticoids is more effective and safe than glucocorticoid in treatment of IgA nephropathy with severe proteinuria.

关 键 词：IGA肾病 糖皮质激素 环孢素 

分 类 号：R586[医药卫生—内分泌]