摘要
本文报告用静脉大剂量环磷酰胺(CTX)(0.75g/m^2)治疗22例重症狼疮性肾炎,其中12例连续治疗3个月以上作为近期疗效的主要观察对象。治疗后蛋白尿及血尿程度显著下降(P<0.001),肾功能逐渐恢复(P<0.05);3例重复肾活检者,病理损害均有不同程度的减轻;血清免疫学异常逐步纠正,补体 C_3,C_4水平均明显上升(P<0.01);A-ds-DNA阳性率及滴度下降(P<0.05);贫血、血小板减少得到纠正或缓解;对肾外症状—关节病变、浆膜炎、癫痫发作及血管炎亦均有疗效。副作用主要有胃肠道反应,白细胞减少、脱发及带状疱疹等,未发现严重感染、出血性膀胱炎及肝功能异常。
Twenty-two patients with severe lupus nephritis received monthly pulse intravenous cyclophosphamide(CTX)(0.75/m/month). Among them,12 cases were treated and followed up for more than three months.There was a marked improvement after pulse CTX with the changes of urinary protien excretion(2.86 vs.0.80g/24-hours,P<0.001),red cell count in urine(163.81 vs.8.41million/ml,P<0.001),serum crea- tinine level(142.15 vs.88.64mmol/L,P<0.05),C_3(0.58 vs.1.12g/L, P<0.01),C_4(0.23 vs.0.43g/L,P<0.01).Clinical symptoms and signs of lupus improved markedly in seizures,serositis,arthritis,vasculitis, anemia and thrombocytopenia.Repeated renal biopsy was performed on 3 cases which showed histological improvement.The side effects of pulse CTX were mild with leukopenia in 6 cases,nausea and vomiting in 6,alope- cia in 4 and herpes zoster in 2.
出处
《医学研究生学报》
CAS
1991年第2期91-94,186,共5页
Journal of Medical Postgraduates
关键词
环磷酰胺
静脉疗法
狼疮性肾炎
cyclophosphamide
therapeutic,intravenous
lupus nephritis
