【摘要】 木文前瞻性对照观察了扁桃体切除对IgA肾病的疗效。41例手术组总缓解率达46.3％。其中尤以反复发作性肉眼血尿型患者的疗效突出,与年龄、病情相似的25例对照组相比,缓解率仅20.0％,有极明显的差异(P<0.02)。而非血尿型患者的手术组与对照组无明显差异。由此认为,扁桃体切除术对以肉眼血尿为主,经常有上感及慢性扁桃体炎的IgA肾病患者,是一项疗效确切而安全的疗法。其疗效的产生是基于清除了慢性感染灶,使外源性抗原物质经粘膜进入体内的机会减少之故。更多还原

【Abstract】 Abstract The pathogenesis of IgA nephropathy is being linked to disorders of mucosal immunity. In particular, exacerbation of macroscopic hematuria are related to infections of tonsils. A controlled trial of therapy by tonsillectomy was performed in patients with IgA nephropathy. There were 41 patients who were al-loted treatment, and 25 patients in the control group. 27 patients in the treatment group presented with macroscopic hematuria, while the remainder presented with urianalysis abnormal. After more than 6 months (6～21 months)follow up, the clini-cal, biochemical, serological, serum IL-2 and IFN-r data of patients were com-pared. The total remission rate (46.3%) of patients treated by tonsillectomy was higher than control (20.5%,P<0.05). It is very striking that a significant effect was found in patients with macroscopic hematuria, they were remitted in 51.9% and improved in 33.3%, only 4 patients have no change after treatment, while in treatment group, the remission rate of patients with urianalysis abnormal have no significant difference as compared with control. It is consided that the tonsillec-tomy is an effective therapy for patients who presented with macroscopic hema-turia, especial in which often suffer from upper respiratory infection and tonsil-litis. The mechanisms of this therapy may be mainly due to romove the infectious focus and prevent pathogenetic antigens invade the body through the mucosa. This result suggest that patients with macroscopic hematuria might be an isolated subset in LgA nephropathy, it has a cIoser relationship with upper respiratory mucosa.更多还原