免疫抑制剂不同冲击疗法治疗狼疮性肾炎的临床研究

目的：探讨免疫抑制剂不同疗法治疗狼疮性肾炎的疗效。方法：46例患者随机分为3组。甲基氢化泼尼松（MP）冲击组：15例患者采用MP1．0g 5％葡萄糖250ml静滴，每日1次，连用3日，以后根据病情可连续应用2－3个疗程。环磷酰胺（CTX）冲击组：15例患者采用CTX0．8－1．0g/1.73m^2静滴，每月1次，连续6－8个月。其他16例患者采用MP联合CTX冲击治疗（MP＋CTX冲击组）：方法同上。每组患者均常规应用泼尼松治疗。在治疗前后检测24小时尿蛋白定量、血肌酐、C3、C4、抗核抗体（ANA）的变化。结果：治疗6个月后，MP组、CTX组及MP＋CTX组对狼疮性肾炎的疗效分别为80．0％、81．3％、和93．3％。各组尿蛋白24小时定量、血肌酐、C3、C4升高治疗前后均有显著性差异（P均＜0．05）；而MP＋CTX组较MP组和CTX组差异更明显（P均＜0．05）。结论：MP与CTX冲击疗法治疗狼疮性肾炎的疗效肯定，而两者联合冲击的疗效更好。

Clinical studies on treatment for lupus nephritis with different lash therapy of immunosuppressive agent

Objective:To investigate the clinically curative effects of different therapeutic mathod of immunosuppressive agent for lupus nephritis(LN).Methods:Fortysix patients with LN were randomly divided into three groups:methylprednisolone(MP) group( n =15) was treated with MP 1 0 g 5% glucose 250 ml infused intravenously once a day for three days as a therapeutic course then based on the patients condition additional 23 therapeutic course could be used. The cyclophosphamide(CTX) group( n=15 ) was treated with CTX 0 81 0 g/1 73 m 2 body surface area (BSA) infused intravenously once a month for 68 months. The MP CTX group( n =16) was treated with MP CTX using the same method as MP and CTX group.Otherwise the conventional prednisone therapy was given to three groups.Before and after therapy the changes in quantitative measurement of 24 hours urinary protein,blood creatinine(Cr),complement C3,C4,and antinuclear antibody(ANA) were detected.Results:After 6month therapy the curative effects on LN were 80 0% in MP group,81 3% in CTX group,and 93 3% in MP CTX group respectively.There were significant differences in quantitative measurement of 24 hours urinary protein,blood Cr,C3,and C4 before and after therapy (all P <0 05) furthermore the differences in MP CTX group compared with MP group and CTX group were much more significant (all P <0 05).Conclusions:The curative effects of MP and CTX on LN are cofirmed and the combined lash therapy using both MP and CTX is much more effective.