两种药物治疗新月体性狼疮性肾炎的疗效比较

Compare of curative effect on creasentic lupus nephritis by two drug treatment

目的比较霉酚酸酯（MMF）与环磷酰胺（CTX）治疗新月体性狼疮性肾炎（CLN）的疗效。方法对MMF组（治疗组）10例和CTX组（对照组）10例进行一般状况、临床表现、病理特征、治疗缓解率、复发率、不良反应发生率及预后的回顾性对比分析。结果两组患者一般状况、临床表现及狼疮活动性指数（SLE-DAI）、病理损害程度间差异无统计学意义，治疗组和对照组治疗12个月时缓解率分别为70％和60％，治疗组完全缓解率（50％）显著高于对照组（30％），复发率（10％）则显著低于对照组（40％）。对照组2例（20％）死亡；治疗组无死亡病例。结论与环磷酰胺方案比较，霉酚酸酯组取得更高的完全缓解率和低复发率，且感染不良反应较少见，安全性好。

Objective To compare the effect relapse rate and outcomes between pulse intravenous cyclopnos- phamide（CTX） and mycophenolate mofeti（MMF） in the induction therapy of crescentic lupus nephritis（CLN） in children. Methods A retrspective comparative analysis in the general situation,clinical performance,patholoped features,ease of treatment, recurrence rate, the indicence of side effects and prognosis was done between the treatment group（ n=10） and the control group（n=10）, Results The results in the general situation,and clinical manifesta- tions of lupus activity index,the pathological damage had no significant difference between the treatment group and the control group for 12 months, remission rates were 60 % and 70 % in the treatment group complete remission rate （50%） was significantly higher （30%）, the recurrence rate （10%） was significantly lower than the control group （30%）. 2 cases of the control group（20%） died;without treatment group died. The side effect of infection was more significant in the CTX group. Conclusion Higher complete remission rates and less infection complications were observed in crescentic lupus nephritis patients who received MMF induction regime than in patients who received intra-venous pulse （CTX） regime.