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目的观察甲基泼尼松龙联合环磷酰胺冲击治疗狼疮肾炎效果是否优于两药单独应用的效果;比较单独应用甲基泼尼松龙和环磷酰胺冲击治疗狼疮肾炎的效果。方法选取广州医学院第二附属医院肾内科2003年2月至2004年11月64例狼疮肾炎患者,随机分为 A 组(甲基泼尼松龙组)、B 组(环磷酰胺组)、C组(甲基泼尼松龙+环磷酰胺组),检测治疗后疾病活动指标:血清抗核抗体、抗 dsDNA 抗体、狼疮活动指数、血清总补体、C 反应蛋白(CRP)和肾炎指标:高倍镜下红细胞个数、24 h 尿蛋白和血清肌酐。结果与A组相比,C 组改善疾病活动相关指标更为明显,B 组差异无显著性;B、C 两组改善肾炎相关指标更为明显,C 组差异更为显著。结论甲基泼尼松龙与环磷酰胺冲击治疗狼疮肾炎效果优于两药单独应用,环磷酰胺冲击治疗对于改善肾炎的临床表现比甲基泼尼松龙冲击治疗更为有效。
Objective To observe whether the effect of methylprednisolon combined with cyclophosphamide in the treatment of lupus nephritis is superior to that of the two drugs alone and the effect of methylprednisolone and cyclophosphamide alone in the treatment of lupus nephritis. Methods Sixty-four patients with lupus nephritis from February 2003 to November 2004 in Department of Nephrology, Second Affiliated Hospital of Guangzhou Medical College were randomly divided into A group (methylprednisolone group), B group (cyclophosphamide group) Group C (methylprednisolone + cyclophosphamide group), the detection of disease activity indicators after treatment: serum anti-nuclear antibody, anti-dsDNA antibody, lupus activity index, total serum complement, C reactive protein (CRP) and nephritis indicators: The number of erythrocytes under high magnification, 24 h urinary protein and serum creatinine. Results Compared with group A, the index of disease activity improvement was more obvious in group C, and there was no significant difference in group B; the index of improving nephritis was more obvious in groups B and C, and the difference was more significant in group C. CONCLUSION: Methylprednisolone and cyclophosphamide are superior to lupus nephritis in the treatment of lupus nephritis. Cyclophosphamide shock treatment is more effective than methylprednisolone in the treatment of nephritis.