摘要
目的：分析大剂量环磷酰胺（ＣＴＸ）冲击疗法治疗重症狼疮性肾炎（ＬＮ）的远期预后。方法：长期随访５年以上的６０例Ⅳ型ＬＮ患者，随访初期血清肌酐（Ｓｃｒ）＜１２４．３μｍｏｌ／Ｌ，随访期平均９６．７（６０～１７０）个月。临床分组为：Ａ组：大剂量ＣＴＸ静脉疗法组；Ｂ组：ＭＰ冲击治疗组；Ｃ组：大剂量激素治疗组。结果：Ａ组，临床病情相对稳定，复发率为１／４９．８月次，明显低于Ｂ组的１／２４．３月次及Ｃ组的１／３２．５月次。５年随访后，Ａ组Ｓｃｒ成倍升高率仅为１０％，而Ｂ组及Ｃ组则明显增加，分别为３０％和３３％。Ａ组患者的严重感染，股骨头坏死，医源性糖尿病等副反应也均明显少于大剂量激素治疗患者。结论：本文资料进一步证实大剂量ＣＴＸ静脉疗法治疗重症ＬＮ能延缓ＬＮ慢性化病变，取得良好的远期预后。
OBJECTIVE To investigate the long term effects of intravenous cyclophosphamide pulse therapy in patients with severe lupus nephritis. METHODOLOGY Sixty patients who fitted four or more criteria for the diagnosis of systemic lupus erythematosus (SLE) and with severe lupus nephritis (LN) were enrolled in this study. All of them were type Ⅳ LN proved by renal biopsy and had been followed up for more than 5 years ( from 60 to 170 months, average 96.7 months). They were divided into three groups: group A (received intravenous cyclophosphamide pulse therapy,(0.5 ～ 0.75 g/m 2BSA ), group B (methylprednisolone pulse therapy) and group C ( oral large dosage of prednisone). RESULTS By the end of this study, rate of LN recurrence was the lowest in group A as compared to those in group B and C. At the end of the follow up, the incidence of doubling serum creatinine was 10% in group A, which was lower than those in group B ( 33% ) and group C ( 30% ). Side effects as infections, osteonecrosis of the femoral head , steroid induced diabetes, were less frequent in group A as compared to those in group B and C. CONCLUSION Our data demonstrate that intravenous cyclophosphamide pulse therapy has a good and long term effect in patients with severe lupus nephritis.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1997年第1期16-19,共4页
Chinese Journal of Nephrology,Dialysis & Transplantation
