VARIOUS CYTOTOXIC DRUG PROGRAMS IN DIFFUSE LUPUS NEPHRITIS

弥漫型系统性红斑狼疮患者 此前进入治疗试验的肾炎继续 被评估。长期研究表明， 肾活检上的疤痕可能会提供重要的预后 信息。轻度心绞痛患者的亚组 口服硫唑嘌呤或环磷酰胺对瘢痕形成有反应 当加入低剂量的皮质类固醇时。患有老年痴呆症的患者 更严重的疤痕不能有效地用那些 药物计划，但可能对静脉推注有反应 环磷酰胺。其相对有效性和毒性。 继续对各种药物计划进行系统评估。 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 药物治疗优于传统的皮质类固醇治疗。好处是 最好的是环磷酰胺。差异是非常大的 意义重大，但只有在实质上进行后续跟进时才明显 超过5年点。间歇性给药 环磷酰胺至少和口服一样有效 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.