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单独使用低剂量环孢素治疗老年膜性肾病患者。

Administration of low-dose cyclosporine alone for the treatment of elderly patients with membranous nephropathy.

作者信息

Li M X, Yu Y W, Zhang Z Y, Zhao H D, Xiao F L

机构信息

Department of Nephrology, The Navy General Hospital, Beijing, China

Department of Nephrology, The Navy General Hospital, Beijing, China.

出版信息

Genet Mol Res. 2015 Mar 30;14(1):2665-73. doi: 10.4238/2015.March.30.27.

Abstract

This study aimed to investigate the effects of administration of low-dose cyclosporine A (CsA) alone and the combination of low-dose CsA and a low-dose hormone for the treatment of elderly patients with membranous nephropathy. We divided 27 patients into two groups as follows: low-dose CsA group (group A) and the group receiving a combination of a low-dose hormone and low-dose CsA (group B). The treatment and follow-up times were ≥ 6 months. We observed no difference in gender, age, serum creatinine levels, estimated glomerular filtration rate (eGFR), and 24-h urinary protein levels between the two groups before treatment; in addition, the rates of complete and partial remission were not different 6 months after treatment. The rate of complications in group B was higher than that in group A (84.6 vs 35.7%, respectively; t = 0.018). While the pretreatment eGFR of patients who achieved remission was significantly higher than that of patients who did not achieve remission, the 24-h urinary protein levels and incidence of hypertension were significantly lower than those of patients who did not achieve remission (t = 0.042, 0.035 and 0.043, respectively). The efficacy of administration of low-dose CsA alone and in combination with a low-dose hormone was similar; the efficacy was related to eGFR, urinary protein levels, and the incidence of hypertension before the treatment. The side effects of administration of CsA alone were significantly lower than those of the combination treatment.

摘要

本研究旨在探讨单独给予低剂量环孢素A(CsA)以及低剂量CsA与低剂量激素联合应用对老年膜性肾病患者的治疗效果。我们将27例患者分为以下两组:低剂量CsA组(A组)和接受低剂量激素与低剂量CsA联合治疗的组(B组)。治疗及随访时间均≥6个月。治疗前,两组患者在性别、年龄、血清肌酐水平、估计肾小球滤过率(eGFR)和24小时尿蛋白水平方面均无差异;此外,治疗6个月后完全缓解和部分缓解率也无差异。B组并发症发生率高于A组(分别为84.6%和35.7%;t = 0.018)。缓解患者的治疗前eGFR显著高于未缓解患者,而24小时尿蛋白水平和高血压发生率显著低于未缓解患者(分别为t = 0.042、0.035和0.043)。单独给予低剂量CsA与低剂量激素联合应用的疗效相似;疗效与治疗前的eGFR、尿蛋白水平和高血压发生率有关。单独应用CsA的副作用显著低于联合治疗。

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