VARIOUS CYTOTOXIC DRUG PROGRAMS IN DIFFUSE LUPUS NEPHRITIS

系统性红斑狼疮肾炎的病因有哪些？ 以前进入治疗试验的药物继续进行评价。 长期研究表明肾活检的疤痕程度 可以提供重要的预后信息。 患者亚组 轻度瘢痕形成对口服硫唑嘌呤或口服 环磷酰胺时，添加到低剂量的皮质类固醇。 患者 这些药物不能有效地治疗更大程度的疤痕 程序，但可能对环磷酰胺的静脉推注有反应。 的 各种药物计划的相对有效性和毒性继续， 进行系统评价。 8-23岁的患者风险更大 发生肾功能恶化的可能性比老年患者高， SLE和肾炎。 狼疮性肾炎患者的长期随访 证明免疫抑制-细胞毒性药物的明显益处超过 常规皮质类固醇治疗。 受益最大的是 环磷酰胺 差异非常显著，但只有 当随访时间大大超过5年时，这一点很明显。

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. Patients aged 8-23 years are at greater risk of developing renal functional deterioration than are older patients with SLE and nephritis. Long-term follow-up of patients with lupus nephritis demonstrate clear-cut 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.