IgA肾病治疗进展

Progress in the treatment of IgA nephropathy

关键词:  IgA肾病  糖皮质激素  药物治疗

Key words:  IgA nephropathy  Glucocorticoid  drug treatment

摘要:

IgA肾病（IgA nephropathy，IgAN）是全球范围内最常见的一种原发性肾小球肾炎。糖皮质激素（Glucocorticoid，GC）被广泛用于治疗IgAN，糖皮质激素受体(glucocorticoid receptor，GR)是人体内广泛存在的细胞内受体，是GC在体内发挥作用的靶点。GC通过与GR结合发挥抑制炎症反应、免疫反应、直接保护足细胞的作用。改善全球肾脏病预后组织指南中也指出GC治疗IgAN的必要性及如何、何时使用。IgAN推荐使用具有肾脏保护作用和减少蛋白尿作用的血管紧张素转换酶抑制剂（angiotensin-converting enzyme inhibitors，ACEI）和/或血管紧张素II受体阻滞剂（angiotensin receptor blockers，ARB）阻断肾素血管紧张素-醛固酮系统，近年来一些新型的制剂如阿利吉仑、过氧化物酶体增殖活化受体γ等已被使用。多靶点治疗也越来越被重视，本文对目前IgAN治疗进展进行综述。

Abstract:

IgA nephropathy (IgAN) is the most common Primary glomerulonephritis in the world. Glucocorticoid (GC) is widely used in the treatment of IgAN. Glucocorticoid receptor (GR) is a widely distributed intracellular receptor in the human body and is the target of GC．GC can inhibit inflammatory and immune response and protect podocytes by combining with GR. The Kidney Disease Improving Global Outcomes also points out the need for GC to treat IgAN and when to use it. Blockade of the reninangiotensin-aldosterone system (RAAS) with angiotensin-converting enzyme inhibitors (ACEI) and/or angiotensin receptor blockers (ARB) is recommended as they have renoprotective and antiproteinuric effects. In recent years, some new Pharmaceutical preparations such as aliskiren, peroxisome proliferator-activated receptor have been used. Multi-target treatment also attracts more and more attention. This article will summarize from the above points.