静脉注射甲基普雷迪尼索隆治疗脏综合征的病变变化最小的成年人:一个随机对照试验
Jinxia Chen1, Ruting Li2, Hua Guo3
1Department of Nephrology, National Clinical Key Specialty Construction Program (2023); Institute of Nephrology; Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City; Affiliated Hospital of Guangdong Medical, Zhanjiang, Guangdong, People's Republic of China.
概括
与单独的口服普得尼松相比,静脉内甲基普得尼索隆诱导,随后是口服普得尼松,在高度 edematous 的最小变化脏综合征 (MCNS) 患者中提供更快的缓解. 这种连续疗法可以提高缓解率,但不会增加复发风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 最小变化瘤综合征 (MCNS) 经常伴有严重的胀,可能会损害口服皮质类固醇的吸收.
- 常规的口服皮质类固醇治疗可能在初始阶段对具有显著的MCNS患者效果较差.
研究的目的:
- 为了比较静脉注射 (IV) 甲基普雷迪尼索隆诱导后口服普雷迪尼松和常规口服普雷迪尼松治疗的疗效.
- 评估高度 edematous MCNS 患者的治疗结果.
主要方法:
- 一个单中心,开放标签,并行臂随机对照试验 (RCT) 涉及117名MCNS患者.
- 患者被随机分配,接受两周的IV甲基普雷迪尼索隆,然后接受口服普雷迪尼索恩或常规口服普雷迪尼索恩治疗.
主要成果:
- 顺序IV-然后-口服组在2周和4周显示出明显更高的总缓解率 (P=.032,P=.027).
- 顺序治疗组的完全缓解 (CR) 速度更快 (14.0天 vs. 16.0天; P=.024),在2周后CR率更高 (63.3% vs. 41.5%; P=.031).
- 两组之间没有观察到复发率或复发时间的显著差异.
结论:
- 连续的IV甲基普雷迪尼索隆诱导,然后是口服普雷迪尼松,在高度 edematous MCNS 患者提供更早的缓解.
- 这种疗法对患有严重的MCNS患者来说是一种潜在的优越治疗选择,而不会影响复发率或安全性.
- 这些发现支持使用短期IV甲基普雷迪尼索隆治疗MCNS中严重的初始治疗.
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