VARIOUS CYTOTOXIC DRUG PROGRAMS IN DIFFUSE LUPUS NEPHRITIS

弥漫型系统性红斑狼疮肾炎患者 目前仍在对以前进行的治疗试验进行评估。 长期研究表明肾活检上的疤痕程度 可提供重要的预后信息。患者的亚群 轻度疤痕对口服硫唑嘌呤或口服有反应 当环磷酰胺与低剂量的皮质类固醇一起使用时。患有疾病的患者 那些药物不能有效地治疗更严重的疤痕 方案，但可能对静脉推注环磷酰胺有反应。这个 各种药物计划的相对有效性和毒性继续 被系统地评估。8-23岁的患者风险更大 比老年患者发生肾功能恶化的可能性更大 系统性红斑狼疮和肾炎。狼疮性肾炎患者的长期随访 证明免疫抑制细胞毒药物的明显益处超过 常规的皮质类固醇治疗。收益最大的是 环磷酰胺。差异是非常显著的，但只有 当随访期大大超过5年时，情况会很明显。

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.