甲强龙治疗IgA肾病36例临床分析

A retrospective study of 36 cases of methylprednisolone therapy in IgA nephropathy

目的:探讨甲强龙冲击并小剂量维持治疗IgA肾病的临床疗效。方法:将我院72例IgA肾病患者分为治疗组和对照组,每组36例,对照组给予洛丁新治疗,治疗组采用甲强龙治疗。观察治疗前后24小时尿蛋白定量等指标。结果:两组间一般资料比较无统计学差异。治疗组尿蛋白完全缓解11例(30.6%),部分缓解20例(55.6%),无缓解5例(13.8%);对照组分别为7例(19.4%),8例(22.2%),21例(58.4%),差异有显著性(P<0.05)。治疗前后,治疗组血肌酐分别为(101.7±26.5)μmol/L及(91.6±28.4)μmol/L;对照组分别为(99.8±27.6)μmol/L及(103.3±26.4)μmol/L,两者比较均差异无显著性(P>0.05)。治疗前后ALB上升、24小时尿蛋白定量、Tch、Scr均下降,差异有显著性(P<0.05)。两组不良反应发生率差异无显著性。结论:甲强龙冲击并小剂量维持治疗IgA肾病能显著减少蛋白尿,维持肾功能稳定。

Objective：To evaluate the effects of methylprednisolone therapy in IgA nephropathy.Methods：72 patients with biopsyproven IgA nephropathy were analyzed retrospectively.The patients were randomly assigned either the control group（36 patients,lotensin） or the therapy group（36 patients,methylprednisolone）.Results：There were no difference in baseline characteristics between the two groups.In the therapy group,11 patients（30.6%） were complete remission,20 patients（55.6%） were part remission and 5 patients（13.8%） were no response,while in the control group,7 patients（19.4%） were complete remission,8 patients（22.2%）were part remission and 21 patients（58.4%） were no response（P〈0.05）.During the follow-up period,serum creatinine concentration was decreased from（101.7±26.5）μmol/L to（91.6±28.4）μmol/L in the therapy group,while in the control group,serum creatinine concentration was increased slightly from（99.8± 27.6）μmol/L to（103.3±26.4）μmol/L,with no significant difference between the two groups（P〉0.05）.Conclusion：Methylprednisolone therapy is effective in reducing proteinuria and protecting renal function in IgA nephropathy.