小児ネフローゼ症候群のステロイド療法に関する臨床的研究 : 尿蛋白分画像の面より
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概要
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The clinical studies were performed to investigate the initial therapeutic effect of steroids and further to examine the response to steroids from a view of the urine protein analysis through a single radial immunodiffusion in 41 cases of idiopathic nephrotic syndrome of childhood and 25 cases of chronic nephrotic nephritis with their chief symptom of hyperproteinuria. 1. The patients with proteinuria well responded to steroid, in whom proteinuria was disappeared and clinical symptoms were improved, were 78.0% in idiopathic nephrotic syndrome and 44.0% in chronic nephrotic nephritis, respectively. 2. I have observed a decrease of proteinuria and an improvement of clinical symptoms in 5 cases of idiopathic nephrotic syndrome and in 5 cases of chronic nephrotic nephritis when steroids were reduced or withdrowed. These cases were considered to be steroid-dependent proteinuria previously reported by Pollak. 3. The urine protein analysis by means of a single radial immunodiffusion revealed a larger amount of albumin and transferrin excretion in idiopathic nephrotic syndrome than other diseases, and a higher level of IgG excretion in acute glomerulonephritis than other diseases. 4. The patients with idiopathic nephrotic syndrome showed greater Al/IgG ratio and Tr/IgG. Especially, the patients well responded to steroids showed a marked decrease of Tr/IgG ratio, and this decrease occurred prior to a decrease of urine protein concentration. This tendency was also observed in patients with chronic nephrotic nephritis. From the results obtained, the urine protein analysis, in particular, examination of alteration of Tr/IgG ratio and transferrin level may be helpful for anticipating the responce to steroids and making scheming the steroid therapy.
- 神戸大学の論文