目的 评价扁桃体切除术联合激素对IgA肾病的疗效.方法 选取42例经肾活检诊断为IgA肾病患者,分为扁桃体切除术联合激素治疗组24例和单用激素治疗组18例.经12个月治疗后,评估扁桃体切除联合激素治疗方法对IgA肾病的疗效.结果 经过12个月的治疗,尿蛋白转阴率联合治疗组为79.2%,高于单用激素治疗组的44.4%(P=0.020),尿潜血转阴率联合治疗组为75.0%,高于单用激素治疗组的16.7%(P＜0.001),尿异常转阴率联合治疗组为62.5%,高于单用激素组的16.7%(P=0.003).结论 扁桃体切除联合激素治疗对IgA肾病具一定疗效.%Objective To evaluate how tonsillectomy plus steroid therapy affects IgA nephropathy in patients. Methods A total of 42 patients were enrolled into 2 groups: 24 cases in tonsillectomy plus steroid therapy group, and 18 cases in steroid therapy group. Oral prednisolone was given at the dose of 1 mg/kg/d for two months, reduced by 5 mg per half a month, and then reduced to 5 mg/d of maintaining. From 7th month, prednisolone was given at the dose of 5 mg/d for 6 months. Serum creatinine levels were compared, and ratios of urinary protein and/or occult blood between the groups were determined. Results After 12 months, the ratio of the urinary protein in tonsillec-tomy plus steroid therapy group was higher than that in steroid therapy group ( P =0. 020 ); occult blood disappeared more in tonsillectomy plus steroid therapy group than in steroid therapy group( P < 0. 001 ); remission of urinary abnormalities were also higher in combined therapy group. Conclusion Tonsillectomy plus steroid therapy can raise clinical remission rate and has beneficial effects on patients with IgA ne-phropathy.
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