狼疮性肾炎的诊疗进展

Progress in Diagnosis and Treatment of Lupus Nephritis

狼疮性肾炎是系统性红斑狼疮的一种常见和严重的并发症,是急性肾损伤和终末期肾病的重要原因。目前认为免疫复合物是狼疮性肾炎发展过程中重要的启动因子。近年,狼疮性肾炎的免疫抑制治疗模式已从单纯皮质类固醇激素发展为皮质类固醇激素联合环磷酰胺或霉酚酸酯治疗。在诱导缓解和长期维持治疗中,也出现了多种新的治疗方案,如神经钙调蛋白抑制剂和生物制剂,为狼疮性肾炎患者提供了更多的选择机会。

Lupus nephritis is a common and serious complication in patients with systemic lupus erythematosus,which is a significant cause of acute renal injury and end-stage nephropathy. Currently, immune complexes have been recognized as an important promoter in the development of lupus nephritis. In recent years, immunosuppressive therapies for lupus nephritis have been developed from corticosteroids alone to corticosteroids combined with cyclophosphamide or mycophenolatemofetil. A variety of new treatments, such as neurocalmodulin inhibitors and biopharmaceuticals, have emerged in the remission induction and long-term maintenance, providing more options for patients with lupus nephritis.