| ABSTRACT Objective:To discuss the curative effects and clinical safety of cyclosporine A combined with union/low dose prednisone on the treatment of progressive IgA nephropathy.Methods:120 cases of progressive IgA nephropathy patients were randomly divided into observation group and control group (60 cases in each group). The control group were given large doses of prednisone and a starting dose of 1.0mg·kg-1·d-1, with the maximum amount of 60mg·d-1; And after 6 weeks of (or urine protein was negative after two weeks) tapering, when reduced to 12 weeks 0.5 mg·kg-1·d-1, all patients were given maintenance treatment. The observation group received cyclosporine A with a starting dose of 100 mg·d-1, and adjusted according to the amount of cyclosporine A, with the maximum not exceeding 5.0 mg·kg-1·d-1, so that concentration of cyclosporin A was maintained at 100 200 mg·ml-1, besides prednisone with a starting dose of 0.5mg· kg-1·d-1, with the maximum amount of 30mg·d-1, which were treated for 6 months. 2 ，4，6，8，12 and 24 weeks after treatment,24 h urinary protein, serum albumin, creatinine, uric acid, and the clinical efficacy and adverse reactions of the two groups were evaluated and compared. Results: In the observation group,4 , 8, 12 and 24 weeks after treatment,the overall response rate was significantly higher than that in the control group (P <0.05). 2 , 4 , 8 , 12 and 24 weeks after treatment in the two groups,24 h urinary protein was all decreased significantly (P<0.05), while observation group was decreased more significantly than control group at the same time( P<0.05). In 4 , 8, 12 and 24 weeks after treatment, serum albumin of observation group was significantly increased than before treatment (P<0.05), and was much higher than control group (P<0.05). There was no significant change on serum albumin of control group during treatment.There were no statistically significant differences on creatinine and uric acid between the two groups before and after treatment (P>0.05). There also has no statistically significant differences on the incidence of adverse reactions between the two groups(P>0.05). Conclusion:Using cyclosporine A combined with union/low dose prednisone to treat progressive IgA nephropathy has better clinical efficacy and higher clinical safety, worthy of promotion. |
