CAJ | 학술논문

目的探讨尿毒清对早期高血压型IgA肾病患者的临床疗效.方法早期高血压型IgA肾病患者,随机分为尿毒清治疗组及非尿毒清对照组,采用前瞻性、双盲、对照研究的方法,进行两组尿蛋白缓解率、完全缓解率以及肌酐倍增、e-GFR变化、终末期肾功能衰竭发生率、重复肾活检指标的比较.结果 49例患者随机分为治疗组(25例)和对照组(24例),两组基本病情无差异.两组治疗6个月尿蛋白缓解率及完全缓解率无统计学意义.40例随访(随访时间6～30个月,中位时间为24个月),治疗组肌酐倍增发生率明显低于对照组,分别为14.3％和42.1％(P ＜0.05),前组肌酐倍增时间延长,两组均无患者进展至终末期肾功能衰竭.随访末尿毒清治疗组e-GFR指标明显高于对照组(87.38±17.9 ml/分vs.76.05 ±23.5ml/分,P=0.007).4例患者(治疗组1例,对照组3例)在随访24个月行重复肾活检,其肾小球硬化及肾小管间质慢性化改变均较首次肾活检时加重.结论尿毒清通过延缓肾功能进展,可用于早期高血压型IgA肾病患者的治疗,成为此类患者早期治疗的一种方法.
목적 탐토뇨독청대조기고혈압형IgA신병환자적림상료효.방법 조기고혈압형IgA신병환자,수궤분위뇨독청치료조급비뇨독청대조조,채용전첨성、쌍맹、대조연구적방법,진행량조뇨단백완해솔、완전완해솔이급기항배증、e-GFR변화、종말기신공능쇠갈발생솔、중복신활검지표적비교.결과 49례환자수궤분위치료조(25례)화대조조(24례),량조기본병정무차이.량조치료6개월뇨단백완해솔급완전완해솔무통계학의의.40례수방(수방시간6～30개월,중위시간위24개월),치료조기항배증발생솔명현저우대조조,분별위14.3％화42.1％(P ＜0.05),전조기항배증시간연장,량조균무환자진전지종말기신공능쇠갈.수방말뇨독청치료조e-GFR지표명현고우대조조(87.38±17.9 ml/분vs.76.05 ±23.5ml/분,P=0.007).4례환자(치료조1례,대조조3례)재수방24개월행중복신활검,기신소구경화급신소관간질만성화개변균교수차신활검시가중.결론 뇨독청통과연완신공능진전,가용우조기고혈압형IgA신병환자적치료,성위차류환자조기치료적일충방법.
Objectives To explore the effect of Niaoduqing treatment for early stage of patients with IgA nephropathy presented with hypertension.Methods A prospective study was performed on early stage of IgA nephropathy patients presented with hypertension,which were randomly divided into two groups:the Niaoduqing group and the control group.The baseline characteristics between the two groups were similar,the efficacy and the outcomes were compared.Results 25 patients in Niaoduqing group and 24 patients in the control group,the total remission rate ( complete remission and partial remission) and the complete remission rate were similar between the two groups.40 patients had follow-up,the median follow-up was 30 months ranged from 6 to 30 months.The rate of doubling of the initial serum creatinine were significantly lower in Niaoduqing group compared to the control group ( 14.3 ％ and 42.1％,respectively,P ＜ 0.05 ).Kaplan-Meier analysis showed the time of doubling of the initial serum creatinine in Niaoduqing group was extended.No patients developed end stage renal disease.Estimates GFR were higher in patients with Niaoduqing group (87.38 ± 17.9 ml/min vs.76.05 ± 23.5 ml/min,P =0.007 ).Conclusions Niaoduqing can be a choice of the treatment for early stage of patients with IgA nephropathy presented with hypertension.