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IgA肾病药物治疗进展 被引量：3

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摘要 IgA肾病是最常见的原发性肾小球疾病,由于其发病机制尚不明确,目前仍无特异性治疗药物。对单纯血尿和病理改变较轻者,主要加强随访观察;血管紧张素转化酶(ACE)抑制剂和含ω-3多不饱和脂肪酸的鱼油可用于大部分病例;不能耐受ACE抑制剂者,可选用血管紧张素受体拮抗剂(ARB)治疗;大量蛋白尿、肾功能损害较轻者可使用糖皮质激素,也可应用细胞毒药物或麦考酚酸酯等免疫抑制剂进行治疗;病情进展较快的高危患者,或应用ACE抑制剂、ARB后尿蛋白未明显降低者可应用糖皮质激素冲击治疗,或使用细胞毒药物或免疫抑制剂等强化治疗。
作者 余毅 谢福安
机构地区 南京军区福州肾病中心
出处 《世界临床药物》 CAS 2005年第2期79-84,90,共7页 World Clinical Drug
关键词 IGA肾病 药物治疗 发病机制 血管紧张素转化酶
分类号 R692.31 [医药卫生—泌尿科学]
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参考文献42

  • 1Sedlacek M.IgA nephropathy[J],2003(01).
  • 2Donadio JV;Grande JP.IgA nephropathy[J],2002(10).
  • 3Usui J;Yamagata K;Kai H.Heterogenesis of prognosis in adult IgA nephropathy, especially with mild proteinuria or mild histological features[J],2001(08).
  • 4Xie Y;Chen X;Nishi S.Relationship between tonsils and IgA nephropathy as well as indications of tonsillectomy[J],2004(04).
  • 5Goumenos DS;Davlouros P;EI-Nahas AM.Prednisolone and azathioprine in IgA nephropathy - a ten-year follow-up study[J],2003(02).
  • 6Suzuki T;Yamamoto T;Ohura M.Clinicopathologic findings relevant to disappearance or relapse of proteinuria following corticosteroid treatment in IgA nephropathy patients with proteinuria of 0.5 to 2.0 g/d[J],2004(03).
  • 7Pozzi C;Andrulli S;Del-Vecchio L;etal.Corticosteroid effectiveness in IgA nephropathy: longterm results of a randomized, controlled trial[J],2004(01).
  • 8Woo KT;Lau YK;Wong KS.ACEI/ATRA therapy decreases proteinuria by improving glomerular permselectivity in IgA nephritis[J],2000(06).
  • 9Praga M;Gutierrez E;Gonzalez E;etal.Treatment of IgA nephropathy with ACE inhibitors: a randomized and controlled trial[J],2003(06).
  • 10Yagi K;Okada M;Yanagida H.Comparison of antiproteinuric effects of two different combination therapies in children with IgA nephropathy[J],2003(04).

二级参考文献15

  • 1Coppo R, Amore A, Gianoglio B,et al. Angiotensin Ⅱ local hyperreactivity in the progression of IgA nephropathy. Am J Kidney Dis, 1993, 21:593-602.
  • 2Lee SM, Rao VM, Franklin WA, et al. IgA Nephropathy: morphologic predictors of progressive renal disease. Hum Pathol ,1982, 13:314-322.
  • 3Katafuchi R, Kiyoshi Y, Oh Y, et al. Glomerular score as a prognosticator in IgA nephropathy: its usefulness and limitation. Clin Nephrol, 1998, 49:1-8.
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  • 6Praga M, Borstein B, Andres A, et al. Nephrotic proteinuria without hypoalbuminemia: clinical characteristics and response to angiotensin-converting enzyme inhibition . Am J Kidney Dis, 1991, 17:330-338.
  • 7Myers BD, Meyer TW. Angiotensin-converting enzyme inhibitors in the prevention of experimental diabetic glomerulopathy. Am J Kidney Dis, 1989, 13:20-24.
  • 8Don BR, Kaysen GA, Hutchison FN, et al. The effect of angiotensin-converting enzyme inhibition and dietary protein restriction in the treatment of proteinuria. Am J Kidney Dis, 1991, 17:10-17.
  • 9Ikoma M, Kawamura T, Kakinuma Y, et al. Cause of variable therapeutic efficiency of angiotensin-converting enzyme inhibitors on glomerular lesions. Kidney Int, 1991, 40:195-202.
  • 10胡伟新,唐政,姚小丹,陈惠萍,樊小兵,刘志红,黎磊石.双倍剂量雷公藤多甙治疗原发性肾病综合征的近期疗效[J].肾脏病与透析肾移植杂志,1997,6(3):210-214. 被引量：119

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世界临床药物
2005年 第2期

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