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核心提示：对IgA肾病感到恐惧的朋友应该有信心了
来自于一位外国学者的文章
studies with the highest power and evidence levels include:……
来自于一位外国学者的文章
studies with the highest power and evidence levels include:
– in 1999 pozzi et al (3) published a randomized controlled trial in igan patients with a gfr above 70 ml/min. patients were randomly a igned to su ortive therapy only or additional corticosteroids. in a recently published, up to 10 year follow-up of that population (4), serum creatinine had doubled in one of 43 patients in the steroid group versus 13 of 43 in the control group. （肾功能正常的iga肾病患者分为两组，最高经过十年的观察，用激素组里43个人只有1个肌酐升高了一倍，不用激素的43人中有13人翻倍）。
– in 1999 yoshikawa et al (5) published a randomized controlled trial in japanese children with normal gfr treated with su ortive therapy or immunosu re ion (corticosteroids plus azathioprine). during two years follow-up proteinuria decreased from 1.0 to 0.9 in controls and from 1.4 to 0.2 g/day in the immunosu re ed group. gfr remained normal in all but one child. side effects in immunosu re ed children included growth retardation.（经过两年观察，用激素加细胞毒药物的一组日本iga肾病患儿尿蛋白从 1.4克/日降到0.2克。不用组两年前1.0克两年后0.9克。）
– in 2000 shoji (6) published a randomized trial in which 8 patients were randomized to receive antiplatelet therapy only, while 11 patients received additional oral prednisolone for one year. proteinuria and histology were improved at one year in the steroid-group. the study mainly dealt with low-risk patients (low blood pre ures, mean gfr normal, mean proteinuria 0.75 g/d). （11个接受激素治疗的的病人一年后发现蛋白尿和肾脏病理明显改善）
– in 2002 ballardie et al (7) published a randomized controlled single-center study on igan patients with progre ive lo of renal function. patients were randomized to prednisolone and cytotoxic agents or su ortive therapy only. renal survival in treated patients showed significantly better preservation of function at 5 years (72% compared to 6% in controls). morbidity attributable to treatment included one case of azathioprine-induced bone marrow su re ion and one of secondary diabetes mellitus. （经过5年的观察，接受激素加细胞毒药物的肾功能已经损害者，肾脏存活率是72%。未用者只有6%）
– in 2003 katafuchi et al (8) published a randomized controlled trial in which 43 patients received oral prednisolone as compared to 47 patients in the control group. whereas renal survival was not improved by the steroid therapy, proteinuria decreased in the steroid group only. an unexplained, significantly higher baseline proteinuria in the steroid group co iderably limits interpretation of this study. （用激素的43个病人和未用的47个病人相比，蛋白尿降低，肾存活率没有区别）
– in 2004 maes et al (9) described a pro ective study in 34 patients with igan and impaired renal function, who were randomized to 2 g mycophenolate mofetil (mmf; n=21) or placebo (n=13). after 3 years of follow up, inulin clearances and proteinuria did not differ between the grou . （对于肾功能不良的iga肾病，经过3年观察，用不用骁悉没有差别） 以上是1999年到2004年发表在权威的国外学术杂志的文章，作者分别是意大利日本英国和比利时的一大群肾科医生.每篇开头提到的randomized controlled trial就是循证医学里最推崇的随机对照研究，俗称a级证据,也就是最可*的证据。后面的中文是我简单的翻译。 这些活生生的数据就摆在眼前，iga肾病患者应该感到宽心了吧。
– in 1999 pozzi et al (3) published a randomized controlled trial in igan patients with a gfr above 70 ml/min. patients were randomly a igned to su ortive therapy only or additional corticosteroids. in a recently published, up to 10 year follow-up of that population (4), serum creatinine had doubled in one of 43 patients in the steroid group versus 13 of 43 in the control group. （肾功能正常的iga肾病患者分为两组，最高经过十年的观察，用激素组里43个人只有1个肌酐升高了一倍，不用激素的43人中有13人翻倍）。
– in 1999 yoshikawa et al (5) published a randomized controlled trial in japanese children with normal gfr treated with su ortive therapy or immunosu re ion (corticosteroids plus azathioprine). during two years follow-up proteinuria decreased from 1.0 to 0.9 in controls and from 1.4 to 0.2 g/day in the immunosu re ed group. gfr remained normal in all but one child. side effects in immunosu re ed children included growth retardation.（经过两年观察，用激素加细胞毒药物的一组日本iga肾病患儿尿蛋白从 1.4克/日降到0.2克。不用组两年前1.0克两年后0.9克。）
– in 2000 shoji (6) published a randomized trial in which 8 patients were randomized to receive antiplatelet therapy only, while 11 patients received additional oral prednisolone for one year. proteinuria and histology were improved at one year in the steroid-group. the study mainly dealt with low-risk patients (low blood pre ures, mean gfr normal, mean proteinuria 0.75 g/d). （11个接受激素治疗的的病人一年后发现蛋白尿和肾脏病理明显改善）
– in 2002 ballardie et al (7) published a randomized controlled single-center study on igan patients with progre ive lo of renal function. patients were randomized to prednisolone and cytotoxic agents or su ortive therapy only. renal survival in treated patients showed significantly better preservation of function at 5 years (72% compared to 6% in controls). morbidity attributable to treatment included one case of azathioprine-induced bone marrow su re ion and one of secondary diabetes mellitus. （经过5年的观察，接受激素加细胞毒药物的肾功能已经损害者，肾脏存活率是72%。未用者只有6%）
– in 2003 katafuchi et al (8) published a randomized controlled trial in which 43 patients received oral prednisolone as compared to 47 patients in the control group. whereas renal survival was not improved by the steroid therapy, proteinuria decreased in the steroid group only. an unexplained, significantly higher baseline proteinuria in the steroid group co iderably limits interpretation of this study. （用激素的43个病人和未用的47个病人相比，蛋白尿降低，肾存活率没有区别）
– in 2004 maes et al (9) described a pro ective study in 34 patients with igan and impaired renal function, who were randomized to 2 g mycophenolate mofetil (mmf; n=21) or placebo (n=13). after 3 years of follow up, inulin clearances and proteinuria did not differ between the grou . （对于肾功能不良的iga肾病，经过3年观察，用不用骁悉没有差别） 以上是1999年到2004年发表在权威的国外学术杂志的文章，作者分别是意大利日本英国和比利时的一大群肾科医生.每篇开头提到的randomized controlled trial就是循证医学里最推崇的随机对照研究，俗称a级证据,也就是最可*的证据。后面的中文是我简单的翻译。 这些活生生的数据就摆在眼前，iga肾病患者应该感到宽心了吧。