论文部分内容阅读
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 analyze the long-term prognosis of severe lupus nephritis (LN) treated with high dose cyclophosphamide (CTX) shock therapy. Methods: Sixty patients with type Ⅳ LN who were followed up for more than 5 years were followed up for a mean of 124.3 μmol / L for Scr and 96.7 (60-170) months for follow - up. The clinical groups were: group A: high-dose CTX vein therapy group; group B: MP impact treatment group; group C: high-dose hormone treatment group. Results: In group A, the clinical condition was relatively stable and the recurrence rate was 1 / 49. August was significantly lower than that in group B at 1 / 24.3 months and in group C at 1/32.5 months. At 5 years of follow-up, the doubling rate of Scr in group A was only 10%, while those in group B and C were significantly increased at 30% and 33%, respectively. A group of patients with serious infections, femoral head necrosis, iatrogenic diabetes and other side effects were significantly less than the high-dose hormone treatment. Conclusion: The data in this paper further confirmed that high-dose CTX vein therapy for severe LN can delay LN chronic disease, and achieved good long-term prognosis.