Клинические и генетические закономерности прогрессирования стероид-резистентного нефротического синдрома у детей и эффективность иммуносупрессивной терапии
Малая масса тела (менее 2500 г) при рождении детей со стероид-резистентным нефротическим синдромом является фактором риска прогрессирования заболевания в виде быстрых темпов снижения скорости клубочковой фильтрации — более 15 мл/мин/1,73 м в год, развития фокально-сегментарного гломерулосклероза и отсутствия эффекта иммуносупрессивной терапии 1-й линии, что подтверждает вклад врожденного дефицита… Читать ещё >
Содержание
- Глава 1. ОБЗОР ЛИТЕРАТУРЫ. СОВРЕМЕННЫЕ ПРЕДСТАВЛЕНИЯ О ПАТОГЕНЕТИЧЕСКИХ ЗАКОНОМЕРНОСТЯХ РАЗВИТИЯ И ПРОГРЕССИРОВАНИЯ СТЕРОИД-РЕЗИСТЕНТНОГО НЕФРОТИЧЕСКОГО СИНДРОМА
- 1. 1. Патогенетические механизмы и факторы риска прогрессирования стероид-резистентного нефротического синдрома
- 1. 2. Клиническое значение мутаций и полиморфных вариантов подоцитарных генов в развитии и прогрессировании стероид-резистентного нефротического синдрома у детей
- 1. 3. Клиническое значение полиморфизма генов ренин-ангиотензиновой системы и эндотелиальной дисфункции в развитии предрасположенности к прогрессированию стероид-резистентного нефротического синдрома
- 1. 4. Иммуносупрессивная терапия стероид-резистентного нефротического синдрома у детей
- Глава 2. ХАРАКТЕРИСТИКА ОБСЛЕДОВАННЫХ ДЕТЕЙ, МЕТОДЫ ИССЛЕДОВАНИЯ И ЛЕЧЕНИЯ
- 2. 1. Организация и дизайн исследования
- 2. 2. Клиническая характеристика обследованных детей
- 2. 3. Общее клиническое, лабораторное и функциональное обследование
- 2. 4. Специальные методы обследования
- 2. 4. 1. Морфологическое исследование ткани почки
- 2. 4. 2. Молекулярно-генетические методы исследования
- 2. 5. Статистическая обработка результатов
- Глава 3. КЛИНИЧЕСКИЕ И МОРФОЛОГИЧЕСКИЕ ПРЕДИКТОРЫ ПРОГРЕССИРОВАНИЯ СТЕРОИД-РЕЗИСТЕНТНОГО НЕФРОТИЧЕСКОГО СИНДРОМА У ДЕТЕЙ
- 3. 1. Клинические предикторы прогрессирования стероид-резистентного нефротического синдрома у детей
- 3. 2. Морфологические предикторы прогрессирования стероид-резистентного нефротического синдрома у детей
- Глава 4. АНАЛИЗ АССОЦИАЦИЙ МУТАЦИЙ И ПОЛИМОРФНЫХ АЛЛЕЛЕЙ ГЕНОВ NPHS2, NPHS1 И TRPC6 С РАЗВИТИЕМ И ПРОГРЕССИРОВАНИЕМ СТЕРОИД-РЕЗИСТЕНТНОГО НЕФРОТИЧЕСКОГО СИНДРОМА У ДЕТЕЙ
- 4. 1. Анализ ассоциаций мутаций и полиморфных аллелей гена NPHS2 с развитием и прогрессированием стероид-резистентного нефротического синдрома у детей
- 4. 2. Анализ ассоциаций мутаций и полиморфных аллелей гена NPHS1 с развитием и прогрессированием стероид-резистентного нефротического синдрома у детей
- 4. 3. Анализ ассоциаций дигенного носительства мутаций и полиморфных аллелей генов NPHS2 и NPHS1 с прогрессированием стероид-резистентного нефротического синдрома у детей
- 4. 4. Анализ ассоциаций мутаций и полиморфных аллелей гена TRPC6 с развитием и прогрессированием стероид-резистентного нефротического синдрома у детей
- 4. 5. Анализ ассоциаций дигенного носительства полиморфных аллелей генов TRPC6 и NPHS1 с прогрессированием стероид-резистентного нефротического синдрома у детей
Глава 5. АНАЛИЗ АССОЦИАЦИЙ ПОЛИМОРФИЗМА ГЕНОВ АСЕ (I/D), AGT (М235Т), AGTR1 (А1166С), eNOS (4а/4Ь), PAI-1 (4G/5G), MTHFR (С677Т) С ПРЕДРАСПОЛОЖЕННОСТЬЮ К ПРОГРЕССИРОВАНИЮ СТЕРОИД-РЕЗИСТЕНТНОГО НЕФРОТИЧЕСКОГО СИНДРОМА У ДЕТЕЙ.
5.1. Анализ ассоциаций полиморфизма гена АСЕ (I/D) с предрасположенностью к прогрессированию стероид-резистентного нефротического синдрома у детей.
5.2. Анализ ассоциаций полиморфизма гена AGT (М235Т) с предрасположенностью к прогрессированию стероид-резистентного нефротического синдрома у детей.
5.3. Анализ ассоциаций полиморфизма гена AGTR1 (А1166С) с предрасположенностью к прогрессированию стероид-резистентного нефротического синдрома у детей.
5.4. Анализ ассоциаций полиморфизма гена eNOS (4a/4b) с предрасположенностью к прогрессированию стероид-резистентного нефротического синдрома у детей.
5.5. Анализ ассоциаций полиморфизма гена PAI-1 (4G/5G) с предрасположенностью к прогрессированию стероид-резистентного нефротического синдрома у детей.
5.6. Анализ ассоциаций полиморфизма гена MTHFR (С677Т) с предрасположенностью к прогрессированию стероид-резистентного нефротического синдрома у детей.
Глава 6. ЭФФЕКТИВНОСТЬ ИММУНОСУПРЕССИВНОЙ ТЕРАПИИ СТЕРОИД-РЕЗИСТЕНТНОГО НЕФРОТИЧЕСКОГО СИНДРОМА У ДЕТЕЙ.
6.1. Эффективность циклофосфана внутривенно при стероид-резистентном нефротическом синдроме у детей.
6.2. Эффективность циклоспорина, А при стероид-резистентном нефротическом синдроме у детей.
6.3. Эффективность микофенолата мофетила при стероид-резистентном нефротическом синдроме у детей.
6.4. Эффективность такролимуса при стероид-резистентном нефротическом синдроме у детей.
6.5. Сравнительная эффективность иммуносупрессивной терапии стероид-резистентного нефротического синдрома у детей.
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