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首页> 外文会议>International Symposium on IgA Nephropathy >Tonsillectomy and Corticosteroid Therapy with Concomitant Methylprednisolone Pulse Therapy for IgA Nephropathy
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Tonsillectomy and Corticosteroid Therapy with Concomitant Methylprednisolone Pulse Therapy for IgA Nephropathy

机译：Tonsillectomy和皮质类固醇治疗，伴随IgA肾病伴甲基新甲酮脉冲治疗

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IgA nephropathy (IgAN) is the most common chronic kidney disease in Japan, but the optimum treatment remains controversial. Our objective was to evaluate the effect of tonsillectomy and corticosteroid therapy combined with methylprednisone pulse therapy in patients at our hospital who had IgAN. Tonsillectomy plus pulse therapy was evaluated in 72 patients (33 men and 39 women) with a diagnosis of IgAN based on renal biopsy who were followed up for more than 1 year. The mean age of the patients was 35.2 +- 10.9 years (range: 20-58 years) and the mean observation period after tonsillectomy was 20.3 +- 9.7 months (range: 12-36 months). After tonsillectomy, steroid pulse therapy was administered (methylprednisolone at 500 mg daily for 3 days) 1-3 times and was followed by oral prednisolone from an initial dose of 30 mg on alternate days that was tapered gradually over one year. At 2 years after tonsillectomy, serum creatinine was unchanged or improved in the majority of patients, but worsened in 5 patients. Hematuria (erythrocytes/HPF) improved from Grade 3.76 (11-30/HPF) to Grade 1.94 (1-5/HPF) on average (we defined the grade of hematuria). None of the patients experienced exacerbation of hematuria. Proteinuria decreased from 1.32g/day to 0.86g/day (65% of the pretreatment value), and only 4 patients showed an increase of proteinuria. Mean protein loss decreased to less than 0.5 g/day in patients with creatinine clearance =90 ml/min and/or patients with initial protein excretion = 1.0 g/day.
机译：IgA肾病（Igan）是日本最常见的慢性肾病，但最佳治疗仍然存在争议。我们的目的是评估扁桃体切除术和皮质类固醇治疗的疗效与患有Igan的医院患者的甲基妥酮脉冲治疗。在72名患者（33名男性和39名女性）中评估了TonsilleCectomy Plus Pulse疗法，其基于肾脏活检的Igan诊断，他被跟进超过1年。患者的平均年龄为35.2±10.9岁（范围：20-58岁）和扁桃体切除术后的平均观察期为20.3 + - 9.7个月（范围：12-36个月）。在扁桃体切除术后，施用类固醇脉冲治疗（每天500mg的甲基己二酮3天）1-3次，然后从30mg的初始剂量的初始剂量逐渐逐渐逐渐逐渐变细。在扁桃体切除术后2年，大多数患者的血清肌酐不变或改善，但在5名患者中恶化。血尿（红细胞/ HPF）平均地从3.76级（11-30 / HPF）到1.94级（1-5 / HPF）（我们定义了血尿的等级）。没有一个患者经历过血尿的恶化。蛋白尿从1.32g /天下降至0.86g /天（预处理值的65％），只有4名患者增加蛋白尿。肌酐清除患者= 90毫升/分钟和/或初始蛋白质排泄患者的平均蛋白质损失降至小于0.5克/天。

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