CAJ | 학술논문

目的观察大剂量环磷酰胺冲击治疗狼疮性肾炎的疗效。方法对64例狼疮肾炎（LN，其尿红细胞>10个/高倍视野，24小时尿蛋白>1g，血肌酐＞133μmol/L)进行大剂量环磷酰胺(CTX)冲击治疗（每月1次，共6次，其后每3月1次，共6次）。结果 49例LN患者达到肾脏损害缓解（24小时尿蛋白<1g；血肌酐<133μmol/L；尿沉渣内红细胞<10个/高倍视野；尿管型消失）。达到肾脏病变缓解所需冲击次数平均为3.6次（1～8次）。每次用CTX剂量均数1.1g（0.6～1.6g）。副作用有闭经（发生率33%）；带状疱疹（发生率13%）；出血性膀胱炎1例。结论此治疗方案治疗LN有效，安全，副作用小。
목적 관찰대제량배린선알충격치료랑창성신염적료효。방법 대64례랑창신염（LN，기뇨홍세포>10개/고배시야，24소시뇨단백>1g，혈기항＞133μmol/L)진행대제량배린선알(CTX)충격치료（매월1차，공6차，기후매3월1차，공6차）。결과 49례LN환자체도신장손해완해（24소시뇨단백<1g；혈기항<133μmol/L；뇨침사내홍세포<10개/고배시야；뇨관형소실）。체도신장병변완해소수충격차수평균위3.6차（1～8차）。매차용CTX제량균수1.1g（0.6～1.6g）。부작용유폐경（발생솔33%）；대상포진（발생솔13%）；출혈성방광염1례。결론 차치료방안치료LN유효，안전，부작용소。
Objective To report on the dosing, efficacy and s ide-effects ofbolus cyclosphamide treatment for lupus nephritis (LN). Methods 64 consecuti ve cases of LN with 10 or more erythrocytes per high -power field, proteinuri a (>1g of protein per day ) and serum creatinine increased (>133μmol/L) were tre ated by bolus therapy with cyclophosphamide (CTX) given monthly for 6 months and then quarterly for 18 months. Results 49 patients had renal remission (defin ed as <10 erythrocytes per high-power field, absence of cellular casts, excreti o n of <1g of protein per day and normal serum creatinine). The mean of doses was 1.1g for each time (0.6-1.6g ), the mean of times of bolus CTX needed was 3.6 (1 -8 times). The adverse events were amenorrhea (in 41% female patients), herpes z oster (in 13% patients ) and hemorrhagic cystitis (in 1 patient). Conclu sion The results indicate that monthly bolus CTX therapy is effective and safe for patients with LN. Its adverse effect is relatively not a serious p roblem.