Belovezhdov N
Vutr Boles. 1985;24(4):55-63.
The results from the treatment of 29 patients with idiopathic nephrotic syndrome are reported: 6--with glomerulonephritis with minimum alterations, 12--with diffuse mesangioproliferative glomerulonephritis and II--with focal and segmental glomerular sclerosis and hyalinosis. Corticosteroids, alone and in case they fail to help, in combination with cyclophosphamide were administered to patients with glomerulonephritis with minimum alterations. The rest of the patients were treated with a combination of anticoagulants (heparin and acenocoumarol), immune-suppressors (azathioprin) and corticosteroids. "Pulse" treatment with 300 mg methylprednisolon intravenously was carried out in single patients. Complete clinical-laboratory remission was attained in 5 out of 6 patients with glomerulonephritis with minimum alterations and in 7 out of 12 patients with diffuse mesangioproliferative glomerulonephritis. No effect was attained in any of the patients with focal and segmental glomerular sclerosis and hyalinosis. With repeated renal biopsy, a transition from glomerulonephritis with minimum alterations and from diffuse mesangioproliferative glomerulonephritis to focal and segmental glomerular sclerosis and hyalinosis was observed.
报告了对29例特发性肾病综合征患者的治疗结果:6例为轻度改变的肾小球肾炎,12例为弥漫性系膜增生性肾小球肾炎,11例为局灶节段性肾小球硬化和玻璃样变。对轻度改变的肾小球肾炎患者单独使用皮质类固醇,无效时联合环磷酰胺。其余患者采用抗凝剂(肝素和醋硝香豆素)、免疫抑制剂(硫唑嘌呤)和皮质类固醇联合治疗。个别患者采用静脉注射300mg甲泼尼龙进行“冲击”治疗。6例轻度改变的肾小球肾炎患者中有5例、12例弥漫性系膜增生性肾小球肾炎患者中有7例实现了完全的临床实验室缓解。局灶节段性肾小球硬化和玻璃样变患者均无疗效。重复肾活检时,观察到轻度改变的肾小球肾炎和弥漫性系膜增生性肾小球肾炎转变为局灶节段性肾小球硬化和玻璃样变。