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氟伐他汀和双嘧达莫对组织学表现轻微且蛋白尿中度的儿童IgA肾病患者蛋白尿及肾功能的影响

Effect of fluvastatin and dipyridamole on proteinuria and renal function in childhood IgA nephropathy with mild histological findings and moderate proteinuria.

作者信息

Kano K, Nishikura K, Yamada Y, Arisaka O

机构信息

Department of Pediatrics, Dokkyo University School of Medicine, Tochigi, Japan.

出版信息

Clin Nephrol. 2003 Aug;60(2):85-9. doi: 10.5414/cnp60085.

Abstract

AIM

In recent reports, some kinds of HMG-CoA reductase inhibitors were able to decrease proteinuria and to improve renal function. Here we aimed to clarify the effect of fluvastatin (an HMG-CoA reductase inhibitor) on proteinuria and renal function in children with mild IgA nephropathy.

PATIENTS AND METHODS

We conducted a prospective controlled study of 30 children who had been recently diagnosed with normocholesterolemic IgA nephropathy following the detection of a minor lesion or of focal mesangial proliferation and moderate proteinuria. The 30 patients were randomly assigned to receive both of 20 mg of fluvastatin and 5 mg/kg of dipyridamole (group 1), or 5 mg/kg of dipyridamole only (group 2) for 1 year.

RESULTS

By the end of the trial, urinary protein, hematuria, BUN and serum creatinine levels had significantly decreased in the patients of group 1 as compared to baseline. Serum total cholesterol, triglyceride and LDL cholesterol levels had significantly decreased, while serum total protein and albumin, and creatinine clearance had significantly increased in group 1 as compared to baseline and group 2. The urinary protein level had significantly decreased in the group 2 patients as compared to baseline, but only slightly.

CONCLUSIONS

The results of this study suggest that fluvastatin and dipyridamole treatment yields an antiproteinuric effect and leads to the amelioration of renal function in moderately proteinuric patients with mild histological IgA nephropathy.

摘要

目的

在最近的报道中,某些种类的HMG-CoA还原酶抑制剂能够降低蛋白尿并改善肾功能。在此,我们旨在阐明氟伐他汀(一种HMG-CoA还原酶抑制剂)对轻度IgA肾病患儿蛋白尿和肾功能的影响。

患者与方法

我们对30名儿童进行了一项前瞻性对照研究,这些儿童在检测到轻微病变或局灶性系膜增生及中度蛋白尿后,最近被诊断为正常胆固醇血症性IgA肾病。30名患者被随机分配接受20毫克氟伐他汀和5毫克/千克双嘧达莫(第1组),或仅接受5毫克/千克双嘧达莫(第2组)治疗1年。

结果

到试验结束时,与基线相比,第1组患者的尿蛋白、血尿、血尿素氮和血清肌酐水平显著降低。与基线和第2组相比,第1组患者的血清总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平显著降低,而血清总蛋白、白蛋白和肌酐清除率显著升高。与基线相比,第2组患者的尿蛋白水平显著降低,但仅略有降低。

结论

本研究结果表明,氟伐他汀和双嘧达莫治疗对轻度组织学IgA肾病的中度蛋白尿患者产生抗蛋白尿作用并导致肾功能改善。

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