论文部分内容阅读
目的：应用双倍剂量雷公藤多甙（ＴⅡ）继以间歇用药维持治疗方案治疗不同临床病理类型的原发性系膜增殖性肾小球肾炎，前瞻性观察其疗效及副反应，确定此一新疗法的临床价值。方法：７９例无氮质血症的原发性系膜增殖性肾小球肾炎患者（ＩｇＡＮ４７例，ＩｇＭＮ１５例，ＭｓＰＧＮ１７例）在连续服用ＴⅡ２ｍｇ／（ｋｇ·ｄ）４周后改为间歇疗法，每日２ｍｇ／ｋｇ，服２周停２周，交替进行，平均随访１９．３周，观察蛋白尿、血尿变化及副反应。结果：４７例尿检异常型ＩｇＡＮ患者中，１９例达临床缓解（４０．５％），５例改善（１０．６％），２３例无效（４８．９％）。其中表现为单纯蛋白尿者疗效最佳，其次为单纯血尿者，蛋白尿伴血尿者疗效最差。１７例ＭｓＰＧＮ患者中，１１例达临床缓解（６４．７％），６例无效（３５．３％）。同样以单纯蛋白尿者疗效最佳，其次为蛋白尿伴血尿者，单纯血尿疗效最差。１５例ＩｇＭＮ患者中，８例达临床缓解（５３．３％），３例改善（２０％），４例无效（２６．７％）。１９例以往曾用足量激素治疗无效的患者中有１２例（６３．２％）经双倍剂量ＴⅡ治疗后获缓解。临床缓解的３８例患者中，缓解时间在４周以内者２６例（６８．４％），６周内者３２例（?
Objective: Double-dose tripterygium glycosides (TII) followed by intermittent maintenance drug treatment of different clinical and pathological types of primary mesangial proliferative glomerulonephritis, prospective observation of its efficacy and side effects to determine this The clinical value of new therapies. Methods: 79 patients with idiopathic mesangioproliferative glomerulonephritis without azotemia (47 cases of IgAN, 15 cases of IgMN and 17 cases of MsPGN) were treated with intermittent therapy after 2 weeks of TII2mg / (kg · d) Daily 2mg / kg, 2 weeks for 2 weeks, alternating with a mean follow-up of 19.3 weeks, observed proteinuria, hematuria and side effects. Results: Of the 47 patients with abnormal urine IgAN, 19 achieved clinical remission (40.5%), 5 improved (10.6%) and 23 failed (48.9%). Which showed the best proteinuria efficacy, followed by simple hematuria, proteinuria with hematuria were the worst. Of the 17 MsPGN patients, 11 achieved clinical remission (64.7%) and 6 were ineffective (35.3%). The same proteinuria with the best efficacy, followed by proteinuria with hematuria, the worst hematuria curative effect. Of 15 IgMN patients, 8 achieved clinical remission (53.3%), 3 improved (20%), and 4 failed (26.7%). Of the 19 patients previously treated with adequate hormone therapy, 12 (63.2%) were relieved after double-dose TII treatment. Thirty-six patients (68.4%) with remission time within 4 weeks, 32 patients within 6 weeks (?