IMMUNOSUPPRESSIVE DRUG THERAPY IN LUPUS GLOMERULONEPHRITIS

增生型肾脏疾病的最佳治疗 与系统性红斑狼疮相关的疾病是有争议的。药效 一种密集的间歇性免疫抑制药物治疗正在进行 在活动期狼疮肾小球肾炎患者中进行评估。相比之下， 在间歇脉冲剂量的皮质类固醇和 环磷酰胺，以及短程和长程脉冲之间 环磷酰胺。接受肾活检的患者记录为活跃 肾小球肾炎用强的松治疗并随机接受 同时(A)每月静脉注射甲基强的松龙6次 3个月，或(B)每月静脉注射环磷酰胺6个月，或 (C)每月给环磷酰胺脉冲治疗6个月，然后维持 每3个月一次的环磷酰胺脉冲方案，再加两次 好几年了。在研究的最后24个月，所有患者继续 隔日接受小剂量强的松治疗。活动性疾病，如表现出来的 因肾功能恶化，蛋白尿增多或恶化 尿沉渣，用增加的泼尼松治疗。比较将会是 由肾功能、肾小球预后良好的数量组成 每种治疗中发生的病理和药物相关毒性。

The optimal treatment of the proliferative forms of kidney disease associated with systemic lupus erythematosus is controversial. The efficacy of intensive, intermittent immunosuppressive drug therapy is being evaluated in patients with active lupus glomerulonephritis. A comparison is being made between intermittent pulse doses of corticosteroid and cyclophosphamide, as well as between a short and long course of pulse cyclophosphamide. Patients with renal biopsy documented active glomerulonephritis are treated with prednisone and randomized to receive concomitantly (a) intravenous pulse methylprednisolone monthly for 6 months, or (b) intravenous pulse cyclophosphamide monthly for 6 months, or (c) pulse cyclophosphamide monthly for 6 months followed by a maintenance regimen of pulse cyclophosphamide 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. Active disease, as manifested by renal functional deterioration, increased proteinuria or worsened urinary sediment, is treated by increased prednisone. Comparison will be made of the number of favorable outcomes of renal function, glomerular pathology and drug related toxicities occurring in each treatment.