三联疗法对系膜增生性肾小球肾炎进展的影响。

Effects of triple therapy on the progression of mesangial proliferative glomerulonephritis.

作者信息

Woo K T, Edmondson R P, Yap H K, Wu A Y, Chiang G S, Lee E J, Pwee H S, Lim C H

出版信息

Clin Nephrol. 1987 Feb;27(2):56-64.

Abstract

Fifty-two pairs of patients with idiopathic diffuse mesangial proliferative glomerulonephritis entered a controlled 3-year prospective trial of a combination regimen of cyclophosphamide, dipyridamole and warfarin. In the treatment group proteinuria decreased significantly (p less than 0.01) and renal function remained stable, but in the control group there was no change in proteinuria and creatinine clearance (Ccr) decreased significantly (p less than 0.01). The time patients with renal impairment in the control group and those in the treatment group took to reach end stage renal failure was significantly different (6.1 years versus 8.9 years, p less than 0.02). Among the patients with IgA nephritis, those in the treatment group (n = 27) had stable renal function and a significant decrease in proteinuria (p less than 0.01) but in the control group (n = 21) there was a significant fall in Ccr (p less than 0.01) and rise in serum creatinine (p less than 0.02) with no change in proteinuria. Among 23 pairs of patients in the study who were matched for renal function and degree of glomerulosclerosis, those in the treatment group had stable renal function and decrease in proteinuria (p less than 0.01) whereas those in the control group had decreased Ccr (p less than 0.01) but no change in proteinuria.

摘要

52对特发性弥漫性系膜增生性肾小球肾炎患者进入了一项为期3年的环磷酰胺、双嘧达莫和华法林联合治疗方案的对照前瞻性试验。治疗组蛋白尿显著下降（p<0.01），肾功能保持稳定，但对照组蛋白尿无变化，肌酐清除率（Ccr）显著下降（p<0.01）。对照组和治疗组肾功能损害患者达到终末期肾衰竭的时间有显著差异（6.1年对8.9年，p<0.02）。在IgA肾病患者中，治疗组（n=27）肾功能稳定，蛋白尿显著下降（p<0.01），但对照组（n=21）Ccr显著下降（p<0.01），血清肌酐升高（p<0.02），蛋白尿无变化。在该研究中23对肾功能和肾小球硬化程度匹配的患者中，治疗组肾功能稳定，蛋白尿下降（p<0.01），而对照组Ccr下降（p<0.01），但蛋白尿无变化。