小児IgA腎症の糸球体内 Cross-linked fibrin に関する研究 : 第二報 抗凝固療法による Cross-linked fibrin の変化

Abstract

The changes of intraglomerular deposits of cross-linked fibrin after the combined therapy (prednisolone, warfarin and dipyridamole) in children with IgA ne- phropathy, who had severe proteinuria, mesangial proliferation and crescents, were inves- tigated. Twenty children were divided into two groups by their response to the combined therapy at six months after administration, as follows : Effective Group, patients with a decrease in proteinuria and hematuria and Ineffective Group, patients without a decrease in proteinuria and hematuria. There were no significant differences between Effective Group and Ineffective Group in activity index and chronicity index at the first biopsy, but Effective Group patients showed a deposition of cross-linked fibrin on the glomeruli of the first biopsy specimen (p＜0.05). In Effective Group patients, crescents, cell infiltration, activity index, segmental sclerosis, tubular aitrophy and chronicity index had significantly decreased in the rebiopsy specimen (p＜0.05), whereas deposition of cross-linked fibrin remained unchanged. These findings suggest that the deposition of cross-linked fibrin on the first biopsy speci- men may predict the response to the combined therapy after six months, but there was no decrease in cross-linked fibrin after the combined therapy.