小剂量环磷酰胺诱导缓解并维持治疗狼疮肾炎的临床研究

Small doses of cyclophosphamide for induction of remission and maintenance therapy for lupus nephritis efficacy

目的探讨小剂量环磷酰胺诱导缓解并维持治疗狼疮肾炎的临床疗效。方法选取80例系统性红斑狼疮的增生性肾小球肾炎患者随机分为研究组和对照组,每组各40例。对照组患者给予大剂量环磷酰胺进行治疗,研究组患者给予小剂量环磷酰胺进行治疗。治疗1年后观察两组患者的临床疗效和不良反应。结果两组患者的24 h尿蛋白定量、ds-DNA抗体、补体C3和SLEDAI等指标与治疗前比较,差异均有统计学意义(P均<0.05)。研究组严重感染和月经紊乱等不良反应的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论小剂量环磷酰胺诱导缓解并维持治疗狼疮肾炎的疗效与传统大剂量环磷酰胺静脉冲击的疗效相当,而不良反应明显减少,值得临床推广。

【Objective】To investigate the low-dose cyclophosphamide for induction of remission and maintain clinical efficacy of the treatment of lupus nephritis.【Methods】80 cases of systemic lupus erythematosus patients with proliferative glomerulonephritis were randomly divided into study group and the control group, 40 cases in each group. In the control group were treated with high-dose cyclophosphamide treatment, the study group were treated with lowdose cyclophosphamide treatment. The clinical efficacy of the two groups of patients and adverse reactions after 1 year of treatment.【Results】24 h proteinuria two groups of patients, ds-DNA antibodies, complement C3 and SLEDAI other indicators compared with before treatment, differences were statistically significant（all P0.05）. The incidence of serious infections and study groups menstrual disorders and other adverse reactions was significantly lower than the control group, differences were statistically significant（P0.05）.【Conclusion】Low-dose cyclophosphamide for induction of remission and maintenance treatment of lupus nephritis efficacy with traditional high-dose intravenous pulse cyclophosphamide considerable efficacy, and adverse reactions decreased, worthy of promotion.