Zimmerman S W, Moorthy A V, Dreher W H, Friedman A, Varanasi U
Am J Med. 1983 Dec;75(6):920-7. doi: 10.1016/0002-9343(83)90864-1.
A prospective trial of warfarin and dipyridamole was performed in patients with membranoproliferative glomerulonephritis. Eighteen completed either a control or treatment year, and 13 completed both a control and treatment year. To obviate the bias of excluding control patients who had renal failure after one year, both an unpaired and a paired analysis were performed. The unpaired analysis compared 10 patients followed for an initial control year with eight patients receiving treatment first. Renal function remained stable over the year in the treated group, but worsened in the control group. Slopes of regression lines for reciprocal serum creatinine values were significantly different between groups (p less than 0.025). Urine protein excretion also decreased in the treated group. Four of 10 control patients had a two-fold increase in serum creatinine levels, but no treatment patient did. In the paired crossover analysis, significant differences in renal function were detected between control and treatment years in six patients whose renal function significantly changed over one of the years. In every instance, there was better preservation of renal function in the treatment year. Urinary protein also decreased significantly over the treatment year compared with the control year. Bleeding was the most frequent complication. These data suggest that warfarin and dipyridamole have a beneficial effect on renal function in membranoproliferative glomerulonephritis.
对患有膜增生性肾小球肾炎的患者进行了一项华法林和双嘧达莫的前瞻性试验。18名患者完成了一年的对照期或治疗期，13名患者完成了一年的对照期和一年的治疗期。为了避免排除一年后出现肾衰竭的对照患者所带来的偏差，进行了非配对分析和配对分析。非配对分析比较了10名先进行初始对照期随访的患者与8名先接受治疗的患者。治疗组的肾功能在这一年中保持稳定，而对照组的肾功能则恶化。两组间血清肌酐倒数的回归线斜率有显著差异（p<0.025）。治疗组的尿蛋白排泄也有所减少。10名对照患者中有4名血清肌酐水平升高了两倍，但治疗组患者中没有出现这种情况。在配对交叉分析中，在6名肾功能在其中一年有显著变化的患者中，检测到对照期和治疗期之间的肾功能有显著差异。在每种情况下，治疗期的肾功能保存得更好。与对照期相比，治疗期的尿蛋白也显著减少。出血是最常见的并发症。这些数据表明，华法林和双嘧达莫对膜增生性肾小球肾炎的肾功能有有益作用。
