CAJ | 학술논문

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。
목적：관찰배포소연합당피질격소치료이대량단백뇨（단백뇨≥3.5g/d）위주요표현적IgA신병적림상효과。방법34례부합조건적IgA신병환자수궤입조배포소연합격소치료조（관찰조，18례）화당피질격소치료조（대조조，16례），기록병비교량조환자치료6개월시적24h뇨단백정량、혈청백단백、혈청기항급신소구려과솔등지표，병관찰량조환자적불량반응。결과량조환자치료6개월시적24h뇨단백정량교치료전현저하강（P균<0.05），혈청백단백수평교치료전현저승고（P균<0.05），치료전후혈청기항수평급eGFR수평차이균무통계학의의，차량조간총유효솔적차이무통계학의의（P=0.311）。량조균무인발생불량반응이퇴출연구자。결론배포소연합당피질격소치료이대량단백뇨위주요표현적IgA신병교단순격소치료기효쾌、료효호，차불량반응소。
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.