小剂量环磷酰胺、甲基强的松龙治疗狼疮性脑病

Evaluation of intravenuous low dose cydophosphamide in the treatment of severe encephalopathy of systemic lupus erythematosus

目的通过应用小剂量环磷酰胺(CTX)和甲基强的松龙(MP)冲击治疗系统性红斑狼疮性脑病,对其方法和疗效进行评价。方法 44例狼疮性脑病患者分别应用大剂量 CTX+MP和小剂量CTX+MP进行冲击治疗,观察两组治疗前后各项临床指标和实验室指标变化及改善情况,进行评价。结果小剂量CTX+MP组近期疗效有效率82.6％,死亡率17.4％,大剂量CTX+MP组有效率 52.4％,死亡率 47.6％,两组差异有显著性(P<0.05)。小剂量组副作用发生率明显小于大剂量组(P<0.01)长期疗效没有显著性差异。结论小剂量CTX+MP组对狼疮脑病有良好疗效,副作用明显少于大剂量CTX+MP组,长期疗效两组相同。

Objectivie To determine the effect of low dose eyclophosphamide ( CTX) and methylprednisolone(MP)in the treatment of severe encephalopathy of systemic lupus erythmatosus. Methods 44 patients with severe encephalopathy of SLE were studied.They were divided to two groups and treated with low dose CTX + MP and high dose CTX + MP separately. The clinical effects were observed.Results The low dose group was more effective than the high dose group(82.6% compared to 52.4%) , and the mortality was lower than the high dose group(17.4% compared to 47.6% )(P < 0.05) .The incidence of side effects were lower in low dose group compared to other group( P < 0.01) . Long time clinical trails demonstrated no significant difference in two groups. Conclusion These results indicated that the low dose eyclophosphamide therapy is a good treatment in severe encephalopathy of systemic lupus erythematosus.