激素联合静脉环磷酰胺冲击治疗对Ⅳ型及Ⅳ+Ⅴ型狼疮性肾炎的疗效

Therapeutic outcomes of hormone combined with intravenous cyclophosphamide in patients with class Ⅳ and class Ⅳ+Ⅴlupus nephritis

目的:观察并评价激素联合静脉环磷酰胺(CTX)冲击治疗对Ⅳ型及Ⅳ+Ⅴ型狼疮性肾炎(LN)的治疗作用。方法:总结我院6年来收治Ⅳ型及Ⅳ+Ⅴ型LN各7例,所有患者均采用激素联合静脉CTX冲击治疗。结果:治疗后Ⅳ型LN组24h尿蛋白定量、血清白蛋白(ALB)、血清肌酐(SCr)、血沉(ESR)、血清补体C3及狼疮活动分数(SLE-DAI)均显著改善(P<0.05或P<0.01);Ⅳ+Ⅴ型LN组除24h尿蛋白定量外,其他指标均显著改善(P<0.01)。两治疗组总有效率相似(P>0.05)。结论:激素联合静脉环磷酰胺(CTX)冲击治疗对Ⅳ型LN及Ⅳ+Ⅴ型LN均有效。

Objective： To observe and evaluate the effect and safety of hormone therapy combined with intravenous cyclophosphamide （CTX） in patients with class IV and class IV＋Vlupus nephritis（LN）. Methods：The clinical data and outcomes were retrospectively analyzed in 14 patients （ class Ⅳlupus nephritis 7, Ⅳ ＋Ⅴupus nephritis 7 ,respectively） undergone hormone therapy in combination with intravenous CTX over the 6 years in our hospital. Results：In patients with class IV LN,the involved indicators and indexes were improved significantly with regard to 24-hour urinary protein,serum albumin （ALB）,serum creatininc （SCr）,erythrocyte sedimentation rate （ESR） , serum complement C3 and SLE-DAI after the therapy described above （P 〈 0. 05 or P 〈 0.01 ） , and the same resuits were found in the patients with Ⅳ ＋Ⅴ LN except for 24 h urinary protein （P 〈 0.01 ）. The therapeutic outcomes were approximately identical in the two groups （ P 〉 0. 05 ）. Conclusion ： Hormone therapy combined with intravenous CTX produces equivalent effect on patients with class Ⅳ or Ⅳ ＋Ⅴ lupus nephritis.