O'Neill W M, Etheridge W B, Bloomer H A
Arch Intern Med. 1979 May;139(5):514-8. doi: 10.1001/archinte.139.5.514.
To evaluate the response of patients with idiopathic rapidly progressive glomerulonephritis (RPGN) to high-dose corticosteroids, we have studied ten consecutive patients with this disorder. All were given 1 g of methylprednisolone intravenously each day for one week and then placed on a high-dose orally administered prednisone regimen. Four of the ten patients with idiopathic RPGN responded with a sustained reduction in the serum creatinine level of at least 50%. The patients who responded were characterized by a symptomatic illness of short duration and normal blood pressure. Renal biopsies in the responding patients showed minimal glomerular and crescentic sclerosis with mild interstitial fibrosis. The nonresponders had a long symptomatic illness with elevated initial blood pressures. The renal tissue in this group had considerable fibrosis of the crescents, glomeruli, and interstitium. The results suggest that a certain group of patients with idiopathic RPGN will improve with high-dose corticosteroid therapy.
为评估特发性快速进展性肾小球肾炎（RPGN）患者对大剂量皮质类固醇的反应，我们研究了连续10例患有这种疾病的患者。所有患者均接受每日1g静脉注射甲基强的松龙，持续一周，然后采用大剂量口服强的松治疗方案。10例特发性RPGN患者中有4例血清肌酐水平持续降低至少50%。有反应的患者表现为病程短且有症状，血压正常。有反应患者的肾活检显示肾小球和新月体硬化轻微，间质纤维化轻度。无反应者病程长且有症状，初始血压升高。该组肾组织的新月体、肾小球和间质有相当程度的纤维化。结果表明，某一组特发性RPGN患者接受大剂量皮质类固醇治疗会有所改善。
