IMMUNOSUPPRESSIVE DRUG THERAPY IN LUPUS GLOMERULONEPHRITIS

环磷酰胺冲击治疗比单用强的松治疗更有效， 狼疮性肾炎的早期症状有哪些这项研究试图定义 甲基强的松龙冲击是否等同于环磷酰胺冲击 保留肾功能，以及是否有差异， 长疗程和短疗程环磷酰胺冲击预防 狼疮的恶化 患者接受泼尼松治疗，并随机接受 伴随（a）甲基强的松龙每月脉冲6个月，或（B） 环磷酰胺，每月一次，持续6个月，或（c）脉冲 环磷酰胺，每月一次，持续6个月，随后为维持方案 每三个月一次，再加两年。在最后的24个月里 在研究中，所有患者继续接受低剂量，隔日 强的松 接受甲基强的松龙冲击治疗的患者有更高的概率 发生肾功能不全的风险比长期服用 环磷酰胺冲击疗程此外，接受治疗的患者 只有短疗程的环磷酰胺脉冲疗法 狼疮的主要恶化比那些接受延长治疗的患者 环磷酰胺冲击疗程

Pulse cyclophosphamide is more effective than prednisone alone in preventing renal failure in lupus nephritis. This study sought to define whether pulse methylprednisolone could equal pulse cyclophosphamide in preserving renal function, and whether there was a difference between long and short courses of pulse cyclophosphamide in preventing exacerbations of lupus. Patients were treated with prednisone and randomized to receive concomitantly (a) pulse methylprednisolone monthly for 6 months, or (b) pulse cyclophosphamide monthly for 6 months, or (c) pulse cyclophosphamide monthly for 6 months followed by a maintenance regimen every 3 months for an additional two years. During the final 24 months of the study, all patients continue to receive low dose, alternate day prednisone. Patients treated with pulse methylprednisolone had a higher probability of developing renal insufficiency than patients treated with the long course of pulse cyclophosphamide. In addition, patients treated with only a short course of pulse cyclophosphamide has a higher probability of major exacerbations of lupus than those treated with the extended course of pulse cyclophosphamide.