间歇大剂量环磷酰胺冲击治疗重症狼疮性肾炎临床研究  

CLINICAL RESEARCH OF TREATMENT OF SERIOUS LUPUS NEPHRITIS WITHINTERMITTENT HIGH DOSAGE OF CYCLOPHOSPHAMIDE

作　　者：邹淑循[1] 王笑云[1] 赵卫红[1] 刘佳[1] 毛慧娟[1] 

机构地区：[1]南京医科大学第一附属医院,南京210029

出　　处：《江苏临床医学杂志》1999年第5期418-420,共3页Journal of Jiangsu Clinical Medicine

摘　　要：目的：探讨间歇静脉注射大剂量环磷酰胺（IV-CTX）治疗重症狼疮性肾炎（LN）的疗效。方法;将146例重症LN患者随机分为3组.A组56例，采用IV-CYX0.6～1.0g加强的松1mg.kg-1／d口服。B组46例，口服强的松1.5mg.kg-1／d），明显狼疮活动时给予静脉注射甲基强的松龙1mg／d，共3d。间歇4d，间歇期口服强的松（剂量同前），7d为1疗程，可连用2～3个疗程。C组44例.口眼强的松1～1.5mg加CTX2mg.kg-1／d）。整个观察时间为2个月。结果：3组治疗结束后免疫学指标均有改善，尿蛋白减少、肾功能好转。组间比较无统计学意义。但3组副反应比较：A组最轻，仅出现轻微而短暂的消化道症状。B组感染率最高。C组以肝功能损害及白细胞减少明显。结论：IV-CTX加中、小剂量强的松龙治疗重症LN，能减少蛋白尿，改善肾功能。与口服大剂量强的松或口服CTX相比疗效等同.且副反应轻微。Ohjective: To investigate the curative effect of intermittent venous injection of high dosage of cyclophosphamide (CTX) on serious lupus nephritis. Method: 146 patients with lupus nephritis were divided into three groups. There are 56, 46, and 44 patients in group A, B, and C, respectively.The treatment of group A was venous injection of CTX plus oral prednisone (1mg. kg-1/d). Group B took prednisone (1. 5mg. kg- 1/d), orally. If patients had active lupus they simultaneously accepted injection of methylprednisolone (1g/d ) three days per week, in the other four days they took prednisone (1. 5mg. kg- 1/d). The method may be repeated two to three times. Group C took prednisone (1～1. 5mg. kg-1/d) ) and CTX (2mg. kg-1/d) orally. The treatment took 2 months. Results: The patients in all three groups got their immunological abnormalities improved, proteinuria decreased and renal function increased. There was no statistic significance of the treatment among the three groups, but the side effects of the treatment had the statistic significance in three groups. The side effects in group A was the least,some patients has the minor and temporary symptoms of gastrointestinal tract. The secondary infection was the highest. The liver damage and white blood cell decrease in group C was more serious than in other groups. Conclusions: High dosage CTX injection in treatment of serious lupus nephritis can decrease proteinuria and improve renal function, and has the same curative effects as oral prednisone or CTX, but the method has less side effects than oral prednisone or CTX.

关 键 词：狼疮性肾炎 环磷酰胺 强的松 冲击疗法 

分 类 号：R593.242[医药卫生—内科学]