不同治疗方法对狼疮性肾炎肾病综合征预后的影响

Effects of various treatment regimens on the prognosis of lupus nephritis associated with nephrotic syndrome

目的观察3种不同的治疗方法对狼疮性肾炎(LN)肾病综合征预后的影响。方法将116例LN肾病综合征患者随机分为:A组,激素加环磷酰胺(CTX)治疗56例;B组,单纯激素治疗32例;C组,不规范使用激素和CTX 28例。结果 A组与B、C组5年内病情复发及重新治疗情况比较,P=0．004、0．029和0．000、0．028。A组与B、c组5年发生肾功能衰竭比较,P=0．002和0．000。A组与B、C组治疗预后比较,P=0．019和0．008。结论激素加CTX治疗LN 肾病综合征能使病情5年内长期缓解,副作用少,很少复发,即使复发也还有重新治疗的机会,肾功能较稳定,病死率低; 而单用激素或不规范使用激素和CTX使病情常不稳定,极易复发,合并症多,重新获得治疗的机会减少,易早期进入肾衰竭期,病死率高。

Objective To observe effect of three different treatment regimens on the prognosis of lupus nephritis （LN） associated with nephrotie syndrome. Methods 116 patients with LN associated with nephrotie syndrome were randomized assigned to three groups： group A （ n = 56）, receiving treatment with hormone plus CTX; group B （ n = 32）, receiving pure hormone treatment; group C （ n = 28）, given unscheduled treatment with hormone and CTX. Results Comparison recurrence and retreated cases within 5 years of group A versus groups B and C, the outcome was P = 0. 004, 0,029 and 0. 000, 0. 028, respectively. Comparison the incidence of renal failure within 5 years of group A versus groups B and C, the outcome was P = 0. 002 and 0. 000. Comparison the prognosis of group A versus groups B and C, the outcome was P = 0. 019 and 0. 008. Conclusion Hormone plus CTX in treatment of LN associated with nephritic syndrome can have a 5 - year remission, less toxicity and recurrence, and have opportunities of retreatment for the recurrence, and get a stable renal function and low fatality rate; but for single use of hormone or unscheduled use of hormone or CTX, the disease were found, and less opportunities of retreatment for the a high fatality rate. progress is unstable and easy to relapse, more complications relapse, is easy to advert to the renal failure stage, and has