Efficacy of prednisolone and mizoribine therapy for diffuse IgA nephropathy
Efficacy of prednisolone and mizoribine therapy for diffuse IgA nephropathy
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DOI：
10.1159/000076243
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发表时间：
2004-01-01
影响因子：
4.2
通讯作者：
Suzuki, H
中科院分区：
文献类型：
--
作者：
Kawasaki, Y;Suzuki, J;Suzuki, H
目的：口服泼尼松龙联合咪唑立宾治疗弥漫性IgA肾炎(IgAN)的研究较少。我们评价了泼尼松龙和咪唑立宾治疗弥漫性IgA肾病的疗效。方法：我们纳入了1992年至1999年期间诊断为弥漫性IgAN伴严重蛋白尿的34例患者。在诊断性肾活检后，患者接受强的松龙、咪唑立宾、华法林和盐酸地拉西普的治疗。观察治疗前后的临床表现、实验室检查及病理改变。结果：治疗6个月后平均尿蛋白排泄量较治疗前明显下降。治疗后血尿发生率低于治疗前。分级指数从第一次活检的4.8±-2.1降至第二次活检的2.3+/-1.7(p<；0.001)，分期指数从第一次活检的4.1+/-1.9降至第二次活检的2.7+/-2.4(p<；0.0 5)。治疗后肾小球和间质的巨噬细胞浸润和α-平滑肌肌动蛋白阳性细胞较治疗前明显减少。在最近的随访中，34名患者中没有一人出现肾功能不全。结论：本研究提示强的松龙联合咪唑立宾治疗有IgAN进展风险的患者是有效的。版权所有(C)2004 S.Karger AG，巴塞尔。
Objective: There have been only a few studies concerning oral prednisolone and mizoribine therapy for diffuse IgA nephritis (IgAN). We evaluated the efficacy of prednisolone and mizoribine therapy for diffuse IgAN. Methods: We enrolled 34 patients who had been diagnosed as having diffuse IgAN with severe proteinuria during the period from 1992 to 1999. Following diagnostic renal biopsy, the patients were treated with prednisolone, mizoribine, warfarin and dilazep dihydrochloride. The clinical features, laboratory data and pathological findings between pre- and post-therapy were investigated. Results: The mean urinary protein excretion after 6 months of treatment had decreased significantly compared to pre- therapy. The incidence of hematuria in post-therapy was lower than that of pre- therapy. The grading index decreased significantly from 4.8 +/- 2.1 at the first biopsy to 2.3 +/- 1.7 at the second biopsy (p < 0.001) and the staging index decreased significantly from 4.1 +/- 1.9 at the first biopsy to 2.7 +/- 2.4 at the second biopsy (p < 0.05). Macrophage infiltration and alpha-smooth muscle actin-positive cells in the glomerulus and interstitial region decreased significantly in post-therapy compared with pretherapy. At the most recent follow-up, none of the 34 patients had renal insufficiency. Conclusions: Our study suggested that prednisolone and mizoribine therapy is effective for those patients with the risk of progression of IgAN. Copyright (C) 2004 S. Karger AG, Basel.