Cattran D C
Clin Nephrol. 1991;35 Suppl 1:S43-7.
The effects of cyclosporin A (CyA, Sandimmun) therapy in various types of primary glomerular diseases are discussed. In membranous nephropathy, the data strongly support a positive effect in this disorder, but there have been no control trials thus far to indicate the risk-benefit ratio, the need for adjunctive therapy such as steroids, or what to expect in terms of time to response or duration of response. The risk of nephrotoxicity needs to be more precisely quantitated both from a functional and pathological perspective. Proper prospective controlled trials are needed to establish the safety and efficacy of CyA in this disease. In both IgA and membranoproliferative glomerulonephritis, the data are more sparse. Although isolated studies have suggested a benefit in both these categories, the risks are also evident and more careful pilot studies are indicated before any further conclusions can be drawn as regards the use of this agent in these disorders.
本文讨论了环孢素A（CyA，山地明）治疗各类原发性肾小球疾病的疗效。在膜性肾病中，现有数据有力地支持了CyA对该病具有积极作用，但目前尚无对照试验来表明其风险效益比、是否需要如类固醇等辅助治疗，以及在反应时间或反应持续时间方面的预期情况。需要从功能和病理角度更精确地量化肾毒性风险。需要进行适当的前瞻性对照试验，以确定CyA在该病中的安全性和有效性。在IgA肾病和膜增生性肾小球肾炎中，相关数据更为稀少。尽管个别研究表明CyA对这两类疾病均有益处，但风险也很明显，在就该药在这些疾病中的应用得出任何进一步结论之前，还需要更谨慎的初步研究。
