肾功能正常的新月体性IgA肾病20例的治疗与观察

Clinical Treatment of Crescentic IgA Nephropathy with Normal Renal Function

目的对比糖皮质激素和环磷酰胺联合治疗与单用糖皮质激素治疗肾功能正常的新月体性IgA肾病的临床疗效。方法选取肾功能正常的新月体性IgA肾病患者20例,随机分为两组,治疗组给予甲泼尼龙冲击后联合应用强的松和环磷酰胺,对照组单独使用强的松,观察两组患者的24h蛋白尿、血尿、血红蛋白、血浆白蛋白、肾功能。结果 2组患者24h尿蛋白定量,血尿、血红蛋白(HGB),白蛋白(ALB),肾功能在治疗前、治疗8周、治疗12周时差异无显著性(P>0.05)。治疗6个月,1年,2年时2组之间HGB,ALB,肾功能有显著差异性(P<0.05)。治疗组较对照组未发现明显的不良反应。结论对于肾功能正常的新月体性IgA肾病应早期积极治疗。

Objective To compare the treatment effects of combined glucocorticoids and cy- clophosphamide with corticosteroids alone in crescentic IgA nephropathy with normal renal function. Methods The 20 crescentic IgA nephropathy patients with normal renal function, were randomly divided into two groups, the treatment group were given methylprednisolone pulse therapy, then combi- nation with prednisone and cyclophosphamide, the control group were given prednisone alone. The 24 -hour proteinuria, hematuria, hemoglobin, plasma albumin, renal function in two groups were observed. Results The 24- hour urinary protein, hematuria, hemoglobin （HGB）, albumin （ALB）, renal function before treatment in two groups and after treatment 8 week and 12 week were no significant difference （ P 〉 0. 05 ）. The HGB, ALB, renal function in two groups after treatment six months, 1 year, 2 year were significant difference （ P 〈 0. 05 ）. No obvious side effects in treatment group than the control group. Conclusion The crescentic with normal renal function should be given early active