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目的回顾性分析小剂量环孢素A(Cs A)单药治疗特发性膜性肾病的疗效。方法回顾性分析2008年9月至2015年12月北京大学第一医院收治的Cs A[1~3 mg/(kg·d)]单药治疗的特发性膜性肾病患者,收集临床随访资料。统计完全缓解率、部分缓解率、无效率,缓解后的复发情况。结果 36例患者符合入选标准。Cs A单药治疗时间为(15.56±8.86)个月,随访均大于12个月。治疗6个月缓解率67.7%(24/36),其中完全缓解11.1%(4/36),部分缓解55.6%(20/36);治疗12个月缓解率58.3%(21/36),其中完全缓解25.0%(9/36),部分缓解33.3%(12/36);5例(20.8%)部分缓解患者复发;在长期随访中,42.9%的缓解患者复发。结论小剂量环孢素A单药治疗特发性膜性肾病有效,可避免联合糖皮质激素治疗的副反应;但应注意缓解后有一定比例的复发。
Objective To retrospectively analyze the curative effect of CsA monotherapy on idiopathic membranous nephropathy. Methods A retrospective analysis of patients with idiopathic membranous nephropathy treated with CsA [1-3 mg / (kg · d)] monotherapy from Peking University First Hospital from September 2008 to December 2015 was collected. Clinical follow-up data . Statistics of complete remission rate, partial remission rate, inefficiency, relapse after remission. Results 36 patients met the inclusion criteria. Cs A monotherapy for (15.56 ± 8.86) months, were followed up for more than 12 months. The 6-month remission rate was 67.7% (24/36), with complete remission of 11.1% (4/36) and partial remission of 55.6% (20/36). The 12-month remission rate was 58.3% (21/36) Complete remission was achieved in 25.0% (9/36), with partial remission of 33.3% (12/36); in 5 (20.8%) partially remission patients relapsed; in long-term follow-up 42.9% of remission patients remitted. Conclusion Small dose of cyclosporin A monotherapy for idiopathic membranous nephropathy is effective and can avoid the side effects of combined glucocorticoid therapy. However, it should be noted that there is a certain proportion of recurrence after remission.