Novel Treatment Approaches to Chronic Glomerulonephritis

慢性腎絲球腎炎的新療法

富野康日已(Tasuhiko Tomino)

《Acta Nephrologica》 14卷2期 (2000/04) Pp. 47-52

摘要

關於腎絲球腎炎病程進展的危險因子中，嚴重蛋白尿、全身性高血壓及腎絲球高壓被認為是促使腎絲球腎炎進入末期腎衰竭的主要因子。因此，目前對腎絲球腎炎病患的治療目標多是針對這幾項因子，如改善蛋白尿及預防高血壓等。慢性腎絲腎炎例如IgA腎病的治療就包括了限鹽及限高蛋白飲食，抗血小板藥物等等。在這類病人目前還可使用ACEIs、AIIRA和鈣拮抗劑，以為保護腎臟之用。至於對這些IgA腎病慢性絲球腎炎病人使用結合療法，例如ACEI併用AIIRA，或使用ACEI加上鈣拮抗劑等新療法，對腎臟的保護療效則還需要進一步大型的觀察與試驗。

關鍵字

抗血球藥物 ； 抗高血壓藥物 ； IgA腎療 ； 腎絲球炎

並列摘要

Among many risk factors for the progression of glomerulonephritis, heavy proteinuria, and systemic and/or glomerular hypertension are considered to be major factors in the progression to end-stage renal failure (ESRF). Thus, the main purpose of treatment is to improve the proteinuria and hypertension in patients with glomerulonephritis. Therapy of chronic glomerulonephritis including IgA nephropathy consists of a protein and salt restricted diet, antiplatelet drugs (dilazep hydrochloride, dipyridamole), corticosteroids, immunosuppressants and antihypertensive drugs. Treatment with angiotensin converting enzyme inhibitors (ACEIs), angiotensin II receptor antagonists (AIIRA) and/or Ca antagonists is usually used in such patients as renoprotective therapy. Further study of combination therapy, i.e. ACEI plus AIIRA or ACEI plus Ca antagonist, is needed to determine renoprotective effects by means of multicenter trials of patients with glomerulonephritis including IgA nephropathy.

並列關鍵字

antiplatelet drug ； antihypertensive drug ； IgA nephropathy ； glomerulonephritis