A double-blind controlled trial comparing cyclophosphamide, azathioprine and placebo in the treatment of lupus glomerulonephritis.
A double-blind controlled trial comparing cyclophosphamide, azathioprine and placebo in the treatment of lupus glomerulonephritis.
复制标题
一项双盲对照试验，比较环磷酰胺、硫唑嘌呤和安慰剂治疗狼疮性肾小球肾炎的效果。
DOI：
10.1002/art.1780170602
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发表时间：
1974
影响因子：
--
通讯作者：
John L. Decker
中科院分区：
文献类型：
--
作者：
A. D. Steinberg;John L. Decker
38例狼疮性肾小球肾炎患者进入为期10周的免疫抑制治疗住院试验。允许他们接受泼尼松≤ 0.5 mg/kg/天治疗肾外表现，并随机分配接受环磷酰胺或硫唑嘌呤或安慰剂。观察治疗前后肾功能、尿沉渣、尿蛋白、抗DNA抗体、补体C3及临床症状的变化。这是首次对两种常用于非恶性疾病的免疫抑制药物进行双盲对照比较。环磷酰胺显著上级硫唑嘌呤和安慰剂的所有六个措施，并为三个肾脏措施单独。在蛋白尿、尿RBC和血清C3方面，环磷酰胺显著优于安慰剂。硫唑嘌呤在任何个体测量中均未显著优于安慰剂。虽然环磷酰胺比硫唑嘌呤有更大的改善作用，但仍需要更多的长期数据来确定两种药物在狼疮性肾小球肾炎常规治疗中的作用。
Thirty-eight patients with lupus glomerulonephritis entered a 10-week in-hospital trial of immunosuppressive therapy. They were permitted prednisone ≤ 0.5 mg/kg/day for extrarenal manifestations and were randomly assigned to receive, in addition, cyclophosphamide or azathioprine or placebo. Renal function, urine sediment, proteinuria, anti-DNA, C3, and symptoms were assessed before and after therapy. This represents the first double-blind controlled comparison of two immunosuppressive drugs commonly used in nonmalignant diseases. Cyclophosphamide was significantly superior to both azathioprine and placebo for all six measures together and for the three renal measures alone. Cyclophosphamide was significantly better than placebo with regard to proteinuria, urinary RBC, and serum C3. Azathioprine was not significantly better than placebo in any individual measure. Although cyclophosphamide led to somewhat greater improvement than did azathioprine, additional long-term data will be necessary to establish the role of either drug in the routine management of lupus glomerulonephritis.