环磷酰胺治疗系统性红斑狼疮方案探讨

Research on the Treatment of Systemic Lupus Erythematosus with Cyclophosphamide

环磷酰胺(CTX)是系统性红斑狼疮(SLE)治疗的基本药物,尤其是对于累及肾脏和中枢神经系统的SLE。CTX联合激素治疗较单独使用激素治疗更有效。SLE患者CTX联合甲泼尼龙静脉治疗与CTX联合强的松口服治疗相比,疗效差异无统计学意义。CTX对SLE的疗效已经在很多临床试验中得到证实,但在看到疗效的同时,还要考虑CTX的副作用,包括感染、性腺抑制和恶性肿瘤等,由此产生了多种不同的治疗方案以及新的可能替代CTX的药物研究。

Cyclophosphamide （CTX） is the basic treatment for systemic lupus erythematosus （SEE） , especially renal and central nervous lupus. Intravenous CTX with oral prednisone was more effective than oral prednisone alone. Compared intermittent pulse CTX plus methylprednisolone with continuous oral CTX plus prednisolone, there was no statistically significant difference in efficacy between the two regimens. Although being proven in many multiple clinical trials, the efficacy of CTX in SLE has to be balanced with toxicity, including infection, gonadal failure, and malignancy. Now there are many newer approaches to CTX and new medicines by which may be challenged in the future.