[1]郑桌龙,林 钢,罗勉那,等.成人IgA肾病免疫抑制治疗的研究进展[J].医学信息,2023,36(14):183-187.[doi:10.3969/j.issn.1006-1959.2023.14.040]
 ZHENG Zhuo-long,LIN Gang,LUO Mian-na,et al.Research Progress on Immunosuppressive Therapy for IgA Nephropathy in Adults[J].Journal of Medical Information,2023,36(14):183-187.[doi:10.3969/j.issn.1006-1959.2023.14.040]
点击复制

成人IgA肾病免疫抑制治疗的研究进展()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年14期
页码:
183-187
栏目:
综述
出版日期:
2023-07-15

文章信息/Info

Title:
Research Progress on Immunosuppressive Therapy for IgA Nephropathy in Adults
文章编号:
1006-1959(2023)14-0183-05
作者:
郑桌龙林 钢罗勉那
(1.广东医科大学肾内研究所,广东 湛江 524001;2.广东医科大学第一附属医院肾内科,广东 湛江 524001)
Author(s):
ZHENG Zhuo-longLIN GangLUO Mian-naet al.
(1.Institute of Nephrology,Guangdong Medical University,Zhanjiang 524001,Guangdong,China;2.Department of Nephrology,the First Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong,China)
关键词:
肾小球肾炎IgA肾病免疫抑制剂
Keywords:
GlomerulonephritisIgA nephropathyImmunosuppressant
分类号:
R692.6
DOI:
10.3969/j.issn.1006-1959.2023.14.040
文献标志码:
A
摘要:
免疫球蛋白A肾病(IgAN)是原发性肾小球肾炎的最常见类型,约20%~40%在20年内发展为终末期肾病(ESRD)。IgAN的治疗方案尚未统一,目前仍然没有能够靶向涉及疾病发病机制的关键途径的特定疗法,目前的建议是基于指南证据水平较低的基础上提出的。本文对IgAN的发病机制及现有免疫抑制治疗方法进行了综述,以期为临床治疗IgAN提供新的方向和参考。
Abstract:
Immunoglobulin A nephropathy (IgAN) is the most common type of primary glomerulonephritis, about 20% to 40% of which develop into end-stage renal disease (ESRD) within 20 years. The treatment of IgAN has not yet been unified, and there is still no specific therapy that can target the key pathways involved in the pathogenesis of the disease. The current recommendations are based on the low level of evidence in the guidelines. This article reviews the pathogenesis of IgAN and the existing immunosuppressive treatment methods of IgAN, in order to provide a new direction and reference for clinical treatment of IgAN.

参考文献/References:

[1]Seikrit C,Rauen T,Floege J.Immunglobulin-A-Nephropathie [Immunoglobulin A nephropathy][J].Internist (Berl),2019,60(5):432-439.[2]Yi J,He Z,Xu S,et al.Efficacy and safety of leflunomide in IgA nephropathy: a systematic review and meta-analysis[J].Int Urol Nephrol,2019,51(11):1987-1998.[3]Tsunoda R,Usui J,Hoshino J,et al.Corticosteroids pulse therapy and oral corticosteroids therapy for IgA nephropathy patients with advanced chronic kidney disease: results of a multicenter, large-scale, long-term observational cohort study[J].BMC Nephrol,2018,19(1):222.[4]Katafuchi R,Ninomiya T,Mizumasa T,et al.The improvement of renal survival with steroid pulse therapy in IgA nephropathy[J].Nephrol Dial Transplant,2008,23(12):3915-3920.[5]Wu H,Fang X,Xia Z,et al.Long-term renal survival and undetected risk factors of IgA nephropathy in Chinese children-a retrospective 1243 cases analysis from single centre experience[J].J Nephrol,2020,33(6):1263-1273.[6]贾卿.免疫抑制剂治疗IgA肾病CKD3-4期患者的有效性及安全性研究[D].西安:空军军医大学,2022.[7]Rauen T,Fitzner C,Eitner F,et al.Effects of Two Immunosuppressive Treatment Protocols for IgA Nephropathy[J].J Am Soc Nephrol,2018,29(1):317-325.[8]Beck N,Walz G,Schneider J.Effect of Cyclophosphamide and Glucocorticoid Therapy in IgA Nephropathy: A Single-Center Retrospective Analysis[J].Kidney360,2022,3(3):506-515.[9]李婉,李琴.强的松联合环磷酰胺治疗增生硬化性IgA肾病疗效及对血肌酐和蛋白尿水平的影响[J].实用医院临床杂志,2021,18(4):99-102.[10]韩亚男.他克莫司联合糖皮质激素治疗儿童原发性IgA肾病的疗效及安全性评价[D].石家庄:河北医科大学,2021.[11]李英楠,安自民.贝那普利联合硫唑嘌呤治疗中等量蛋白尿IgA肾病的疗效分析[J].华北煤炭医学院学报,2011,13(4):471-472.[12]沈世忠,杨忠民,蔡佳盈,等.来氟米特与泼尼松对免疫球蛋白A肾病的临床疗效与安全性研究[J].中国临床药理学杂志,2016,32(1):6-8.[13]杨莉萌,梁燕.糖皮质激素联合来氟米特对IgA肾病患者TLR-9、VCAM-1水平的影响[J].医学理论与实践,2021,34(10):1689-1691.[14]Du B,Jia Y,Zhou W,et al.Efficacy and safety of mycophenolate mofetil in patients with IgA nephropathy: an update meta-analysis[J].BMC Nephrol,2017,18(1):245.[15]Liu X,Dewei D,Sun S,et al.Treatment of severe IgA nephropathy: mycophenolate mofetil/prednisone compared to cyclophosphamide/prednisone[J].Int J Clin Pharmacol Ther,2014,52(2):95-102.[16]Hou JH,Le WB,Chen N,et al.Mycophenolate Mofetil Combined With Prednisone Versus Full-Dose Prednisone in IgA Nephropathy With Active Proliferative Lesions: A Randomized Controlled Trial[J].Am J Kidney Dis,2017,69(6):788-795.[17]张沛,周昱,高春林,等.咪唑立宾联合糖皮质激素治疗儿童IgA肾病的临床研究[J].东南国防医药,2022,24(4):356-361.[18]Xie Y,Huang S,Wang L,et al.Efficacy and safety of mizoribine combined with losartan in the treatment of IgA nephropathy: a multicenter, randomized, controlled study[J].Am J Med Sci,2011,341(5):367-372.[19]沈炎.他克莫司治疗原发性IgA肾病伴轻中度肾功能损伤的随机对照临床研究[J].中西医结合心血管病电子杂志,2017,5(22):187.[20]Kim YC,Chin HJ,Koo HS,et al.Tacrolimus decreases albuminuria in patients with IgA nephropathy and normal blood pressure:a double-blind randomized controlled trial of efficacy of tacrolimus on IgA nephropathy[J].PLoS One,2013,8(8):e71545.[21]包红梅,郭文岗,任稹,等.他克莫司联合激素治疗原发性IgA肾病伴轻中度肾功能损伤的疗效观察[J].医学综述,2016,22(14):2884-2887.[22]Xu L,Liu ZC,Guan GJ,et al.Cyclosporine A combined with medium/low dose prednisone in progressive IgA nephropathy[J].Kaohsiung J Med Sci,2014,30(8):390-395.[23]田燕,曾春兰.环孢霉素A与环磷酰胺联合激素对重症IgA肾病的疗效比较[J].中外医学研究,2021,19(18):143-145.[24]李俊杰,张勇.环孢霉素A与环磷酰胺联合激素对重症IgA肾病的疗效比较[J].河南医学研究,2018,27(18):3328-3330.[25]于国俊,罗方,程新,等.免疫抑制作用下雷公藤藤多甙片治疗IgA肾病效果观察[J].世界中医药,2018,13(11):2781-2784.[26]Chen N,Huang HL,Yang YD.Long-term effects of immunosuppression treatment on IgA nephropathy: a systematic review and meta-analysis[J].Ann Palliat Med,2021,10(11):11830-11839.[27]Ballardie FW,Roberts ISD.Controlled prospective trial of prednisolone and cytotoxics in progressive IgA nephropathy[J].J Am Soc Nephrol,2002,13(1):142-148.[28]Hidaka Y,Tamura H,Furuie K,et al.Cyclosporine therapy could be considered for membranoproliferative glomerulonephritis with immunoglobulin A deposits: a case report[J].BMC Nephrol,2022,23(1):358.[29]Lv J,Wong MG,Hladunewich MA,et al.Effect of Oral Methylprednisolone on Decline in Kidney Function or Kidney Failure in Patients With IgA Nephropathy: The TESTING Randomized Clinical Trial[J].JAMA,2022,327(19):1888-1898.[30]Robert T,Cambier A,Hertig A.Intensive Supportive Care plus Immunosuppression in IgA Nephropathy[J].N Engl J Med,2016,374(10):991.[31]Rauen T,Wied S,Fitzner C,et al.After ten years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy[J].Kidney Int,2020,98(4):1044-1052.[32]Pattrapornpisut P,Avila-Casado C,Reich HN.IgA Nephropathy: Core Curriculum 2021[J].Am J Kidney Dis,2021,78(3):429-441.[33]Zhang YM,Zhou XJ,Zhang H.What Genetics Tells Us About the Pathogenesis of IgA Nephropathy: The Role of Immune Factors and Infection[J].Kidney Int Rep,2017,2(3):318-331.[34]Beckwith H,Medjeral-Thomas N,Galliford J,et al.Mycophenolate mofetil therapy in immunoglobulin A nephropathy: histological changes after treatment[J].Nephrol Dial Transplant,2017,32(suppl_1):i123-i128.[35]Lv J,Liu L,Hao C,et al.Randomized Phase 2 Trial of Telitacicept in Patients With IgA Nephropathy With Persistent Proteinuria[J].Kidney Int Rep,2022,8(3):499-506.

相似文献/References:

[1]刘 枫.IgA肾病与系膜增生性肾炎临床特征的比较[J].医学信息,2019,32(16):95.[doi:10.3969/j.issn.1006-1959.2019.16.029]
 LIU Feng.Comparison of Clinical Features between IgA Nephropathy and Mesangial Proliferative Nephritis[J].Journal of Medical Information,2019,32(14):95.[doi:10.3969/j.issn.1006-1959.2019.16.029]
[2]黄 婷,张亚莉,李 燕,等.不同性别IgA肾病患者相关临床指标及病理特点对比[J].医学信息,2019,32(21):125.[doi:10.3969/j.issn.1006-1959.2019.21.040]
 HUANG Ting,ZHANG Ya-li,LI Yan,et al.Comparative Analysis of Clinical and Pathological Features of Patients with Different Sex IgA Nephropathy[J].Journal of Medical Information,2019,32(14):125.[doi:10.3969/j.issn.1006-1959.2019.21.040]
[3]陈钰泱,石爱杰.缬沙坦联合前列地尔治疗慢性肾小球肾炎的效果[J].医学信息,2020,33(15):151.[doi:10.3969/j.issn.1006-1959.2020.15.048]
 CHEN Yu-yang,SHI Ai-jie.The Effect of Valsartan Combined with Alprostadil on Chronic Glomerulonephritis[J].Journal of Medical Information,2020,33(14):151.[doi:10.3969/j.issn.1006-1959.2020.15.048]
[4]刘永芳,王 莹.付义主任治疗IgA肾病经验[J].医学信息,2020,33(21):155.[doi:10.3969/j.issn.1006-1959.2020.21.048]
[5]陈 越,彭 莉.黄芪对细胞毒素相关蛋白A诱导的大鼠系膜细胞外基质分泌的影响[J].医学信息,2022,35(15):104.[doi:10.3969/j.issn.1006-1959.2022.15.023]
 CHEN Yue,PENG Li.Effect of Astragalus Membranaceus on CagA-induced Extracellular Matrix Secretion of Rat Mesangial Cells[J].Journal of Medical Information,2022,35(14):104.[doi:10.3969/j.issn.1006-1959.2022.15.023]
[6]袁茜宁,董怡晨,卿玲玲,等.不同蛋白尿水平IgA肾病患者的临床及病理特征分析[J].医学信息,2024,37(08):104.[doi:10.3969/j.issn.1006-1959.2024.08.020]
 YUAN Qian-ning,DONG Yi-chen,QING Ling-ling,et al.Analysis of Clinical and Pathological Characteristics of IgA Nephropathy Patients with Different Proteinuria Levels[J].Journal of Medical Information,2024,37(14):104.[doi:10.3969/j.issn.1006-1959.2024.08.020]

更新日期/Last Update: 1900-01-01