环胞素A与环磷酰胺治疗狼疮性肾炎疗效的对比研究  

Comparison of Curative Effects of Cyclosporin A and Cyclophophamide on Treating Lupoid Nephritis

作　　者：郑颜萍[1] 王建新[2] 叶任高[3] 

机构地区：[1]海南省农垦总局医院肾内科,海口570311 [2]福建省泉州市第一医院内儿科,泉州362000 [3]中山医科大学附属第一医院肾脏研究所,广州510080

出　　处：《中国中西医结合肾病杂志》2001年第4期209-211,共3页Chinese Journal of Integrated Traditional and Western Nephrology

摘　　要：目的 :为探讨环胞素A(CsA)治疗狼疮性肾炎 (LN)的疗效和安全性 ,并寻求一个预防其减量或停药后复发的理想治疗方案。方法 :采用目前治疗LN较好的环磷酰胺 (CTX)冲击疗法作为对照组 ,与改进的CsA治疗方法(即在CsA减量时加用CTX ,待CTX达到药效时停CsA)进行对比观察。结果 :本组资料显示CsA组与CTX组总体疗效相同 ,而在血沉下降 ,尿蛋白减少 ,血清白蛋白上升 ,ds -DNA滴度下降 ,补体C3 升高方面 ,CsA组较CTX组快 ,CsA组病人观察 1年无 1例复发。结论 :说明CsA对LN有明显疗效 ,能减少激素和CTX的用量及副作用 ,更重要的在CsA逐渐减量的过程中加用CTX ,从而能减少CsA减量及停药后复发 ,小剂量短时间用药很少出现严重的肝肾毒性 ,对重征LN ,开始用CsA诱导治疗临床缓解 ,之后继续用CTX替代CsA维持治疗 ,可能是一种行之有效的方案 ,值得进一步临床多中心。Objective:To verify the curative effects and safety of cyclosporin A(CsA)treating lupoid nephritis(LN)and to find a therapy to prevent remission when dosage of CsA deduced or when CsA was no longer given.Methods:Patients in the control group were treated with sudden dose onset of Cyclophophamide (CTX).Subjects in the treatment group were given CTX when CsA was deduced,and CsA was stopped when CTX’s curative effects were observed.Results:Our data showed that CsA and CTX have almost the same effect,but CsA had more rapid effects on decrease of erythrocyte sedimentation rate,urine protein,and titer of anti-ds DNA and increases of serium albumin and complement 3 than those of CTX.No recurrence has been observed in the CsA treated group,for 1 year follow-up survey.Conclusion:Our observation showed that CsA is effective in treating LN and can deduce the dosage of bormones and CTX,which have side effects.And more importantly,CTX addition during CsA gradual deduction can prevent recurrence of the disease following the termingation of CsA.Hepatorenal toxicity was rarely seen when it was administered in small dosage and for short term.For severe LN,CsA,that CTX intead of CsA maintenance therapy was given when clinic remission was acquired was an effective remedy.The therepic procedure is worthy of further investigation.

关 键 词：环胞素A 环磷酰胺 狼疮性肾炎 治疗 

分 类 号：R593.242[医药卫生—内科学]