Abstract：
BACKGROUND: Tonsillectomy with steroid pulse therapy (TSP) and tonsillectomy monotherapy (T) have improved the prognosis of patients with immunoglobulin A nephropathy (IgAN). However, a consensus has not been reached on the best treatment for these patients. This study aimed to compare the efficacies of TSP and T.
METHODS: Data of patients with IgAN who received TSP or T were retrospectively analyzed. The exclusion criterion was a serum creatinine level > 1.5 mg/dL. The clinical remission and renal survival rates were compared.
RESULTS: Patients were divided into groups based on the treatment method: the TSP (n = 82) and T groups (n = 41). No significant differences were observed in patient characteristics, except for the observation period (TSP: 60 months, T: 113 months). The log-rank test revealed that the clinical remission rate was significantly higher in the TSP group than in the T group (p < 0.05). The superiority of TSP was also observed in the urinary protein excretion (> / = or < 1 g/day) of the two subgroups. According to the Cox proportional-hazards model, the treatment method and daily urinary protein extraction were independent factors affecting clinical remission. The 10-year renal survival rates in the TSP and T groups were 100% and 92.5%, respectively. The log-rank test revealed a tendency for a higher renal survival rate in the TSP group than in the T group (p = 0.09).
CONCLUSIONS: The clinical remission rate was significantly higher with TSP than with T, regardless of urinary protein levels. TSP tended to have a better renal survival rate than T.
METHODS: Data of patients with IgAN who received TSP or T were retrospectively analyzed. The exclusion criterion was a serum creatinine level > 1.5 mg/dL. The clinical remission and renal survival rates were compared.
RESULTS: Patients were divided into groups based on the treatment method: the TSP (n = 82) and T groups (n = 41). No significant differences were observed in patient characteristics, except for the observation period (TSP: 60 months, T: 113 months). The log-rank test revealed that the clinical remission rate was significantly higher in the TSP group than in the T group (p < 0.05). The superiority of TSP was also observed in the urinary protein excretion (> / = or < 1 g/day) of the two subgroups. According to the Cox proportional-hazards model, the treatment method and daily urinary protein extraction were independent factors affecting clinical remission. The 10-year renal survival rates in the TSP and T groups were 100% and 92.5%, respectively. The log-rank test revealed a tendency for a higher renal survival rate in the TSP group than in the T group (p = 0.09).
CONCLUSIONS: The clinical remission rate was significantly higher with TSP than with T, regardless of urinary protein levels. TSP tended to have a better renal survival rate than T.
摘要：
背景：扁桃体切除术联合类固醇脉冲疗法（TSP）和扁桃体切除术单一疗法（T）改善了免疫球蛋白A肾病（IgAN）患者的预后。然而,对于这些患者的最佳治疗尚未达成共识。本研究旨在比较TSP和T的疗效。
方法：回顾性分析接受TSP或T的IgAN患者的数据。排除标准是血清肌酐水平>1.5mg/dL。比较两组患者的临床缓解率和肾脏生存率。
结果：根据治疗方法将患者分为：TSP组（n=82）和T组（n=41）。患者特征没有观察到显著差异，除了观察期(TSP：60个月，T：113个月）。对数秩检验显示，TSP组的临床缓解率明显高于T组（p<0.05）。在两个亚组的尿蛋白排泄（>/=或<1g/天）中也观察到TSP的优越性。根据Cox比例风险模型，治疗方法和每日尿蛋白提取是影响临床缓解的独立因素。TSP组和T组的10年肾脏生存率分别为100%和92.5%,分别。对数秩检验显示，TSP组的肾脏存活率高于T组（p=0.09）。
结论：TSP组临床缓解率明显高于T组，不管尿蛋白水平。TSP往往比T.具有更好的肾脏存活率。
方法：回顾性分析接受TSP或T的IgAN患者的数据。排除标准是血清肌酐水平>1.5mg/dL。比较两组患者的临床缓解率和肾脏生存率。
结果：根据治疗方法将患者分为：TSP组（n=82）和T组（n=41）。患者特征没有观察到显著差异，除了观察期(TSP：60个月，T：113个月）。对数秩检验显示，TSP组的临床缓解率明显高于T组（p<0.05）。在两个亚组的尿蛋白排泄（>/=或<1g/天）中也观察到TSP的优越性。根据Cox比例风险模型，治疗方法和每日尿蛋白提取是影响临床缓解的独立因素。TSP组和T组的10年肾脏生存率分别为100%和92.5%,分别。对数秩检验显示，TSP组的肾脏存活率高于T组（p=0.09）。
结论：TSP组临床缓解率明显高于T组，不管尿蛋白水平。TSP往往比T.具有更好的肾脏存活率。
