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中华肾病研究电子杂志 ›› 2012, Vol. 01 ›› Issue (02) : 98 -102. doi: 10.3877/cma.j.issn.2095-3216.2012.02.008

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紫癜性肾炎的循证治疗
徐丽梨1, 王伟铭1,()   
  1. 1.200025,上海交通大学医学院附属瑞金医院肾脏科
  • 收稿日期:2012-11-08 出版日期:2012-12-18
  • 通信作者: 王伟铭

Evidence-based treatment for Henoch-Schonlein purpura nephritis

Li-li XU1, Wei-ming WANG1,()   

  1. 1.Renal Division, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2012-11-08 Published:2012-12-18
  • Corresponding author: Wei-ming WANG
引用本文:

徐丽梨, 王伟铭. 紫癜性肾炎的循证治疗[J/OL]. 中华肾病研究电子杂志, 2012, 01(02): 98-102.

Li-li XU, Wei-ming WANG. Evidence-based treatment for Henoch-Schonlein purpura nephritis[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2012, 01(02): 98-102.

紫癜性肾炎(HSPN)临床表现多样,可伴有呼吸和消化系统的损害,以儿童多见,成年人的发病率正逐年升高;其预后与临床表现(蛋白尿、血尿)和病理严重程度相关。肾脏病全球预后改善组织(KIDGO)指南发布了HSPN的规范化诊疗方案,并提供了循证医学证据。临床表现较轻的HSPN,持续蛋白尿0.5 ~ 1.0 g/(d . 1.73 m2),推荐给予血管紧张素转化酶抑制剂(ACEI)或血管紧张素受体阻滞剂(ARB)类药物治疗;临床表现较重的HSPN,经ACEI和ARB类药物治疗后,仍持续蛋白尿 > 1 g/(d . 1.73 m2)且GFR > 50 ml/(min . 1.73 m2)的患者,可加用糖皮质激素治疗6个月。

Clinical manifestations of Henoch-Schonlein purpura nephritis (HSPN) are diverse,with respiratory and digestive system damage. Children incidence is higher than adults' incidence which is increasing year by year. The prognosis of HSPN is associated with clinical manifestations (proteinuria,hematuria) and pathological severity. Kidney Disease: Improving Global Outcomes (KIDGO) guideline has released the HSPN standardized diagnosis and treatment plan according to evidence-based medicine.The recommended therapy for HSPN patients with persistent proteinuria [0.5 - 1.0 g/(d . 1.73 m2)] is angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB). And severe patients who still show persistent proteinuria [>1 g/(d . 1.73 m2)]with GFR over 50 ml/(min . 1.73 m2) after treatment with ACEI or ARBs, should be added with a 6-month course of corticosteroid therapy.

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