环孢素A联合小剂量激素治疗特发性膜性肾病31例临床分析

目的特发性膜性肾病(IMN)是肾病综合征的主要病理类型之一,因其对激素不敏感而易于成为难治性肾病综合征,本文通过观察环孢素A+小剂量激素治疗IMN的临床疗效,探讨其治疗。方法观察31例经肾活检证实诊断的IMN患者对环孢素A(CsA)+小剂量激素的治疗反应。治疗方法为环孢素A2～3mg·kg-1·d-1(CsA血药浓度120～150mg/L)8周,继以1～2mg·kg-1·d-1(CsA血药浓度80～100mg/L)维持12～24个月;泼尼松给予0.25mg·kg-1·d-1开始,8周后每2周逐渐减量至0.125mg·kg-1·d-1维持。观察尿蛋白排出量、血浆蛋白和症状体征。结果完全缓解率52%,部分缓解率35%,未缓解13%,有效率达87%。结论环孢素A联合小剂量激素治疗IMN疗效肯定。

Effect of Cyclosporin A Combined with Small Dose of Hormone on Idiopathic Membranous Nephropathy

Objective To study the therapy of idiopathic membranous nephropathy (IMN) with cyclosporin A and small dose of hormone. Methods 31 patients with nephritic syndrome caused by idiopathic membranous nephropathy were enrolled. Cyclosporin A was given at 2 ～ 3 mg·kg-1·d-1 for 8 weeks,then 1 ～ 2 mg·kg-1·d-1 and sustained for 12 ～ 24 months; Prednisone began at 0.25 mg·kg-1·d-1,decreased to 0.125 mg·kg-1·d-1 and sustained after 8 weeks. Results 52% patients obtained complete remission,35% obtained partial remission and 13% got non-remission. The total effective rate was 87%. Conclusion Cyclosporin A combined with small dose of hormone on idiopathic membranous nephropathy is an effective therapy.