间歇小剂量环磷酰胺治疗12例狼疮肾炎慢性肾功能不全的临床分析

目的 探讨间歇小剂量环磷酰胺(CTX)治疗狼疮肾炎(LN)慢性肾功能不全的有效性及安全性.方法 给予12例LN慢性肾功能不全氮质血症期患者间歇小剂量CTX治疗,用量为200-400mg每2～4周,随访2个月～5年,观察12例患者治疗前后的临床转归及实验室改变.结果 12例患者疾病活动度(SLEDAI)明显下降.肾功能得到不同程度的改善,9例患者肾功能不全逆转,肌酐降至正常水平,3例仍处于氮质血症期,但较治疗前有所改善.无明显不良反应发生.结论 间歇小剂量CTX治疗LN是有效、安全、可行的.但肾功能能否长期改善尚有待大样本的临床观察及长期随访.

Clinical evaluation of intermittent low-dosage cyclophosphamide in the treatment of 12 eases with lu-pus nephritis related chronic renal insufficiency

Objective To explore the efficacy and safety of intermittent low-dosage intravenous (Ⅳ) cyelophosphamide (CTX) in treating lupus nephritis (LN) related chronic renal insufficiency. Methods Twelve patients with chronic renal insufficiency with azotemia caused by lupus nephritis received intermittent low-dosage eyclophosphamide therapy (200-400 mg/2～4 weeks) for 2 month to 5 years. We monitored their clinical outcomes and laboratory parameters changes. Results SLEDAI significantly decreased in all cases. Renal function was improved in varying grees. Nine cases had their renal function tests returned to normal range and another 3 cases were still in azotemia. No severe adverse effects occurred. Conclusion The treatment is effective and safe. But it is necessary to carry out large samples and long-term follow-up clinical studies to evaluate its effects on renal function changes.