Rostoker G, Belghiti D, Ben Maadi A, Rémy P, Lang P, Weil B, Lagrue G
Department of Nephrology, Hôpital Henri-Mondor, Créteil, France.
Nephron. 1993;63(3):335-41. doi: 10.1159/000187219.
Fifteen patients with nephrotic idiopathic membranous nephropathy (MN) with predictors of poor outcome were treated with a long cyclosporin A (CyA) regimen at the dose of 4-5 mg/kg/day for a median period of 15 months (range 12-30). Four of the 15 patients did not respond to CyA, and the therapy was discontinued after 4 months. A partial remission (proteinuria < 2 g/day) was observed in 7 of 15 patients and a complete remission (proteinuria < 0.2 g/day) in 4 of 15 patients; good results (partial+complete remission) were, thus, obtained in 11 of 15 patients (73%). Two patients are still receiving therapy. A relapse of the nephrotic syndrome occurred in 3 of 9 patients on withdrawal of CyA, but the relapse remained sensitive to CyA. Side effects were mild. We conclude that CyA may be efficient in the treatment of MN and should be evaluated in controlled trials.
15例患有特发性膜性肾病（MN）且预后不良预测指标的患者接受了长疗程环孢素A（CyA）治疗，剂量为4-5mg/kg/天，中位疗程为15个月（范围12-30个月）。15例患者中有4例对CyA无反应，治疗4个月后停药。15例患者中有7例出现部分缓解（蛋白尿<2g/天），15例患者中有4例出现完全缓解（蛋白尿<0.2g/天）；因此，15例患者中有11例（73%）取得了良好效果（部分缓解+完全缓解）。2例患者仍在接受治疗。9例患者在停用CyA后有3例肾病综合征复发，但复发对CyA仍敏感。副作用较轻。我们得出结论，CyA可能对MN治疗有效，应在对照试验中进行评估。
