Cyclosporin A therapy for Henoch-Schonlein nephritis with nephrotic-range proteinuria
Cyclosporin A therapy for Henoch-Schonlein nephritis with nephrotic-range proteinuria
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DOI：
10.1007/s00467-010-1723-7
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发表时间：
2011-03-01
影响因子：
3
通讯作者：
Pai, Ki Soo
中科院分区：
文献类型：
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作者：
Park, Jee Min;Won, Sung Chul;Pai, Ki Soo
为探讨环孢素A（CyA）对过敏性肾炎（HSN）的治疗作用，对29例（男18例，女11例）肾性蛋白尿患者进行回顾性分析。诊断过敏性紫癜（HSP）时的平均年龄为8.6岁（范围2.0-15.5岁）。所有患者在HSP诊断后平均4.4个月（0-50.7个月）出现肾病蛋白尿。CyA治疗的平均持续时间为12.3个月（范围2.6-55.0个月）。从CyA治疗开始，平均随访时间为3.7年（范围1.2-12.9年）。开始CyA治疗后，类固醇逐渐减少并逐渐停止。所有患者均在平均1.8个月（范围1周至3.5个月）内对CyA治疗作出反应。23例患者达到稳定缓解，平均随访时间为3.2年，6例患者似乎成为CyA依赖，因为他们在治疗停止时出现蛋白尿。除1例CyA治疗依从性差的终末期肾病患者外，所有患者的肾功能均得以保留。我们的结论是，CyA治疗HSN显示肾病范围的蛋白尿是非常有效和安全的方法，虽然有些患者成为CyA依赖。
To evaluate the therapeutic role of cyclosporin A (CyA) for the treatment of Henoch-Schonlein nephritis (HSN), 29 patients (18 boys, 11 girls) with nephrotic-range proteinuria were analyzed retrospectively. Mean age was 8.6 years (range 2.0-15.5 years) at diagnosis of Henoch-Schonlein purpura (HSP). All patients had developed the nephrotic-range proteinuria at a mean interval of 4.4 months (range 0-50.7 months) after the diagnosis of HSP. Mean duration of CyA treatment was 12.3 months (range 2.6-55.0 months). Mean follow-up times were 3.7 years (range 1.2-12.9 years) from the beginning of the CyA treatment. Steroids were tapered off and stopped gradually after initiation of CyA. All patients responded to the CyA treatment within a mean of 1.8 months (range 1 week to 3.5 months). Twenty-three patients achieved stable remission with mean follow-up duration of 3.2 years and 6 patients seemed to become CyA-dependent, since they developed proteinuria when the treatment was stopped. Renal function was preserved in all patients but one who developed end-stage renal disease after poor compliance with CyA. We concluded that CyA treatment for HSN showing nephrotic-range proteinuria is very effective and a safe method, although some patients become CyA-dependent.