@article{oai:u-ryukyu.repo.nii.ac.jp:02010497,
 author = {饒波, 正史 and 喜友名, 朝則 and 喜瀬, 乗基 and 杉田, 早知子 and 近藤, 俊輔 and 又吉, 宣 and 真栄田, 裕行 and 我那覇, 章 and 古波蔵, 健太郎 and 鈴木, 幹男 and Noha, Masashi and Kiyuna, Asanori and Kise, Norimoto and Sugita, Sachiko and Kondo, Shunsuke and Matayoshi, Sen and Maeda, Hiroyuki and Ganaha, Akira and Kohagura, Kentaro and Suzuki, Mikio},
 issue = {1},
 journal = {耳鼻咽喉科免疫アレルギー},
 month = {},
 note = {IgA 腎症に対し口蓋扁桃摘出術とステロイドパルス療法を併用し6 年以上の長期経過観察を実施しえた44 症例を対象に，長期腎機能予後と遺残扁桃・ワルダイエル輪の代償性肥大・炎症所見について調査した。低・中リスク群では27 例中26 例で腎機能が保持されていた。一方，高・超高リスク群では，腎機能保持は8 例，腎機能低下は8 例（2 例の末期腎不全・透析導入）となっていた。腎機能維持のためには腎機能が保たれている早期に口蓋扁桃摘出術＋ステロイドパルス治療を行うことが重要と推定された。口蓋扁桃遺残は9% であった。アデノイド肥大は軽度が多いが，舌扁桃は19% に肥大を認めた。しかし，口蓋扁桃遺残，アデノイド肥大，舌扁桃肥大と腎機能予後には明らかな関係を認めなかった。炎症所見はアデノイドでは発赤，びらん，膿汁付着を陽性所見とし，舌扁桃では膿栓があるものを陽性所見とした。鼻咽腔ファイバー検査を実施できた42 例中，23 例は両方に炎症所見なし，5 例で上咽頭のみ炎症所見あり，7 例で舌扁桃のみ炎症所見あり，4 例で上咽頭及び舌扁桃に炎症所見ありであった。透析に至った2 例中1 例では上咽頭に炎症所見を認めた。上咽頭，舌扁桃の炎症所見の有無と腎機能予後に明らかな関連を認めなかった。IgA 腎症における口蓋扁桃摘出術後の長期予後と，上咽頭炎の関係を明らかにするためにさらなる調査が必要である。, The aim of this study is to evaluate long-term efficacy of tonsillectomy in patients with IgA nephropathy. Forty-four patients were enrolled six years past after receiving tonsillectomies for treatment of IgA nephropathy. Renal function, such as serum creatinine, estimate glomerular filtration rate (eGFR), and blood urea nitrogen (BUN), and optic endoscopic examination of hypertrophy and inflammatory finding of adenoid and lingual tonsil were examined. Patients were divided into two groups; low and moderate risk group for progression to end-stage renal disease (ESRD), and high and super high risk group for progression to ESRD. Of 27 patients in low and moderate risk group, 26 kept sufficient renal function. On the contrary, half of patients in high and super high risk group showed worse renal function and two of them received renal dialysis. Therefore, tonsillectomy is effective for patients who have a normal or subnormal renal function. Residual tonsil was observed in 9% of subjects. Although lymphatic hypertrophy in lingual tonsil was observed in 19%, adenoid vegetation was usually small. There was no significant relationship between renal function outcome and residual tonsil, adenoid vegetation and lingual tonsil hypertrophy. There were 9 cases with inflammatory findings in nasopharynx. The further investigation is needed for clarify the relationship between epipharyngitis and long-term outcome of tonsillectomy for IgA nephropathy., 論文},
 pages = {1--6},
 title = {IgA 腎症に対する口蓋扁桃摘出術の長期効果},
 volume = {36},
 year = {2018}
}