KDIGO肾小球肾炎临床实践指南-干部科.ppt

百令胶囊 百令胶囊能有效减少24h尿蛋白，提高血白蛋白，降低血脂，减轻肾小球高滤过，阻止其向肾小球硬化发展。 百令胶囊促进肾小管上皮细胞的再生修复，对肾小管具有保护作用。 百令胶囊具有免疫调节作用，能抵抗或减轻激素副作用，提高患者的免疫力，有利于全身症状的改变。 百令胶囊与其他药物(激素+ACEI或CTX)联用有协同作用，增强药物疗效，同时减轻激素药物和免疫抑制剂的毒副作用。 百令胶囊功效 百令胶囊可明显改善肾功能，抑制PTH和MMS，降低CRF毒素潴留。 百令胶囊能促进蛋白质合成及氨基酸利用，促进正氮平衡，纠正血浆必需氨基酸缺乏现象，延缓肾衰进展。 百令胶囊能改善CRF患者的微炎症反应，延缓肾衰竭进展。 in one small RCT of 28 adult MCD patients that compared prednisone 125 mg every other day for 2 months with placebo, there was no difference in overall remission rates over 77 months follow-up, although a significant percentage of the placebo arm ended up being treated with prednisone over this time frame. However, patients treated with prednisone went into remission more rapidly; 12 of 14 treated patients were in complete remission before 2 months, compared to 6 of 14 controls.124,136 * Survival from renal failure in patients with complete (CR), partial (PR), and no remission (NR). One patient in the NR group had a creatinine clearance 15 ml/min per 1.73 m2 at presentation and was excluded from the survival analysis. Another study used tacrolimus as initial therapy in six patients and noted a remission in all.181 单中心前瞻性观察性研究 6例活检证实的FSGS成人患者，以肾病综合征为首发症状，给予FK506单药治疗（FK506治疗组） 另有5例FSGS患者已获缓解但因肾功能持续恶化而从环孢素A改为FK506治疗（转换治疗组） FK506给药方案 起始剂量4mg/d口服，一天两次给药 12小时谷浓度维持在4~7ng/mL FK506治疗组平均随访12.8±5.5个月；转换治疗组平均随访16.1±6.2个 * Another study used tacrolimus as initial therapy in six patients and noted a remission in all.181 单中心前瞻性观察性研究 6例活检证实的FSGS成人患者，以肾病综合征为首发症状，给予FK506单药治疗（FK506治疗组） 另有5例FSGS患者已获缓解但因肾功能持续恶化而从环孢素A改为FK506治疗（转换治疗组） FK506给药方案 起始剂量4mg/d口服，一天两次给药 12小时谷浓度维持在4~7ng/mL FK506治疗组平均随访12.8±5.5个月；转换治疗组平均随访16.1±6.2个 * Segarra et al.190 treated 25 patients with cyclosporine-resistant or cyclosporine-dependent FSGS.Tacrolimus was used in a dose of 0.15 mg/kg/d and targeted to trough levels of 5–10 mg/l; there was a 100% remission rate in the cyclosporine-dependent patients, 100% in patients who had developed resistance to cyclosporine, and 62% in patients with resistance to the in