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目的:探讨难治性狼疮性肾炎(LN)的治疗方案。方法:多靶点治疗组(多靶点组)采用环磷酰胺(CTX)、他克莫司方案治疗,将其与经典环磷酰胺方案组(CTX组)及麦考酚吗乙酯治疗组(MMF组)的疗效进行比较。结果:治疗6个月时,多靶点组的完全缓解率和治疗有效率虽高于CTX组和MMF组,但无统计学意义(P>0.05)。药物不良反应的观察中,多靶点组的胃肠道症状发生率较CTX组和MMF组低,且有统计学意义(P<0.05)。结论:多靶点治疗对难治性LN的疗效较CTX组和MMF组有一定优势,不良反应少,安全性高,但有待探讨进一步降低医疗成本、提高远期疗效及用药安全性的联合治疗方案。
Objective: To investigate the treatment of refractory lupus nephritis (LN). Methods: Multi-target therapy group (multi-target group) was treated with cyclophosphamide (CTX) and tacrolimus and treated with CTX and mycophenolate mofetil (MMF group) the efficacy of comparison. Results: At 6 months, the complete remission rate and therapeutic efficiency of multi-target group were higher than that of CTX group and MMF group (P> 0.05). In the observation of adverse drug reactions, the incidence of gastrointestinal symptoms in multi-target group was lower than that in CTX group and MMF group (P <0.05). Conclusions: The multi-target therapy has some advantages over CTX and MMF in adverse refractory LN, with fewer adverse reactions and high safety. However, the combination therapy to further reduce the medical costs and improve the long-term efficacy and drug safety needs to be explored Program.