VARIOUS CYTOTOXIC DRUG PROGRAMS IN DIFFUSE LUPUS NEPHRITIS

弥漫型系统性红斑狼疮患者 以前进入治疗试验的肾炎继续， 被评价。 长期研究表明， 肾活检上的瘢痕可能提供重要的预后 信息. 具有轻微程度的 对口服硫唑嘌呤或口服环磷酰胺有反应的瘢痕 当添加到低剂量的皮质类固醇。 患者 更大程度的疤痕不能有效地治疗那些 药物计划，但可能会对静脉推注 环磷酰胺 的相对有效性和毒性 继续对各种药物方案进行系统评估。 狼疮性肾炎患者的长期随访 证明免疫抑制-细胞毒性的清除益处 而不是传统的皮质类固醇治疗。 经济效益 环磷酰胺最好。 差异非常大 重要，但只有在后续行动实质上 超过5年。 间歇性大剂量 环磷酰胺至少与口服环磷酰胺一样有效 环磷酰胺，毒性小得多。

Patients with the diffuse forms of systemic lupus erythematosus nephritis previously entered into therapeutic trials continue to be evaluated. Long-term studies suggest that the degree of scarring on the renal biopsy may provide important prognostic information. The subset of patients with a mild degree of scarring responds to oral azathioprine or oral cyclophosphamide when added to low doses of corticosteroids. Patients with a greater degree of scarring are not effectively treated with those drug programs, but may respond to intravenous boluses of cyclophosphamide. The relative effectiveness and toxicity of various drug programs continues to be systematically evaluated. Long-term follow-up of patients with lupus nephritis demonstrate clear-out benefit of immunosuppressive-cytotoxic drugs over conventional corticosteroid therapy. The benefit was greatest with cyclophosphamide. The differences are highly significant, but only are apparent when follow-up is substantially beyond the 5 year point. Intermittent boluses of cyclophosphamide are at least as effective as oral cyclophosphamide and are much less toxic.