Kobayashi Y, Fujii K, Hiki Y, Tateno S
Q J Med. 1986 Oct;61(234):935-43.
Forty-three patients with IgA nephropathy whose proteinuria persisted between 1.0 and 2.0 g/day were assessed in an uncontrolled pilot study of steroid treatment. Fourteen patients receive an initial dose of 40 mg/day of prednisolone, followed by gradual reduction of the dose over an average period of about 19 months. After discontinuation of corticosteroids, they were treated with non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs to the end of the study. Another 29 patients received non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs throughout the study. Fourteen patients treated with steroids experienced considerable reduction in proteinuria and maintained renal function over 81 months. In 29 patients treated with non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs alone, proteinuria did not decrease and renal function deteriorated significantly during 60 months. At the end of the study, differences in degree of proteinuria and in levels of renal function between the steroid and non-steroid groups were statistically significant. In addition, these differences became more distinct in patients with initial creatinine clearance values 70 ml/min or more in both groups. These results suggest that treatment with steroids in IgA nephropathy may be beneficial, especially in the early stage of the disease.
在一项关于类固醇治疗的非对照试验性研究中，对43例蛋白尿持续在每日1.0至2.0克之间的IgA肾病患者进行了评估。14例患者接受了初始剂量为每日40毫克的泼尼松龙治疗，随后在约19个月的平均时间内逐渐减少剂量。停用皮质类固醇后，他们在研究结束前接受非甾体抗炎药和/或抗血小板药物治疗。另外29例患者在整个研究过程中接受非甾体抗炎药和/或抗血小板药物治疗。14例接受类固醇治疗的患者蛋白尿显著减少，并在81个月内维持了肾功能。在仅接受非甾体抗炎药和/或抗血小板药物治疗的29例患者中，蛋白尿在60个月内没有减少，肾功能显著恶化。在研究结束时，类固醇组和非类固醇组之间的蛋白尿程度和肾功能水平差异具有统计学意义。此外，两组中初始肌酐清除率值在70毫升/分钟或以上的患者，这些差异变得更加明显。这些结果表明，IgA肾病患者使用类固醇治疗可能有益，尤其是在疾病的早期阶段。
