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作者报道用环磷酰胺(cyclophosphamide)间歇疗法治疗3例难治性类风湿性关节炎,其中2例并用甲基强的松龙冲击治疗,3例均获长期缓解。 3例患者均为女性,年龄分别是60、51和50岁,类风湿性关节炎病史各为4、6及25年。曾用强的松、金制剂、青霉胺、硫唑嘌呤及左旋咪唑等治疗无效,改用口服环磷酰胺。例1开始口服100mg/d,白细胞降为2,900时剂量减至50mg/d。由于白细胞减少而采用间歇疗法,每3天服100mg,随后每4天服100mg,症状完全消除。例2开始时采用甲基强的松龙冲击疗法,静注1g/d连续4天,另口服环磷酰胺100mg/d。由于疾病活动性不减轻而反复采用甲基强的松龙冲击治疗,1年后发生白细胞减少症,因而改为间歇给予环磷酰胺,每3天100mg,随后每4天
The authors reported intermittent treatment with cyclophosphamide in 3 patients with refractory rheumatoid arthritis, 2 of which were treated with methylprednisolone and 3 patients with long-term remission. All 3 patients were female, aged 60, 51 and 50 years, respectively, and had a history of rheumatoid arthritis of 4, 6 and 25 years respectively. Had used prednisone, gold preparations, penicillamine, azathioprine and levamisole treatment ineffective, switch to oral cyclophosphamide. In Example 1, the dosage was reduced to 50 mg / d by 100 mg / d orally and leukocyte reduced to 2,900. Intermittent therapy due to leukopenia, 100 mg every 3 days, followed by 100 mg every 4 days, the symptoms completely eliminated. Example 2 began using methylprednisolone impact therapy, intravenous 1g / d for 4 consecutive days, the other oral cyclophosphamide 100mg / d. Cyclophosphamide was intermittently given to cyclophosphamide at intervals of 100 mg every 3 days and then every 4 days after repeated use of methylprednisolone impact treatment due to no reduction in disease activity