CAJ | 학술논문

对于中重度及系统应用糖皮质激素治疗抵抗的寻常型天疱疮患者,临床上常联合免疫抑制剂治疗.环磷酰胺联合地塞米松冲击疗法应用广泛,临床试验证实有效.联合环磷酰胺可以减少糖皮质激素激素的用量,优于环孢素、硫唑嘌呤.一般不推荐口服环磷酰胺.国内缺乏设计科学的随机对照临床试验.其不良反应需要长期随访,尤其应警惕发生严重感染、致癌和生育能力受损.概述环磷酰胺的使用方法、对地塞米松环磷酰胺冲击治疗的相关评估、常规用法、不良反应及预防等,尤其权重随机对照临床试验、诊疗指南及系统评价文献.
대우중중도급계통응용당피질격소치료저항적심상형천포창환자,림상상상연합면역억제제치료.배린선알연합지새미송충격요법응용엄범,림상시험증실유효.연합배린선알가이감소당피질격소격소적용량,우우배포소、류서표령.일반불추천구복배린선알.국내결핍설계과학적수궤대조림상시험.기불량반응수요장기수방,우기응경척발생엄중감염、치암화생육능력수손.개술배린선알적사용방법、대지새미송배린선알충격치료적상관평고、상규용법、불량반응급예방등,우기권중수궤대조림상시험、진료지남급계통평개문헌.
Immunosuppressive agents are often combined to treat patients with moderate to severe pemphigus vulgaris resistant to systemic glucocorticoids.Cyclophosphamide in combination with dexamethasone pulse therapy has been widely used and proven effective in clinical trials.It has been indicated that cyclophosphamide is superior to cyclosporine and azathioprine with a steroid-sparing benefit.Oral cyclophosphamide is not recommended.At present,there is a lack of reasonably designed randomized controlled clinical trials on this subject in China.Long-term follow-up is required to evaluate its side effects,such as complicated infections,carcinogenicity,and impaired fertility.Based on relevant literature,especially reports on randomized controlled clinical trials,guidelines on diagnosis and treatment,and systematic reviews,the authors review the usage of,clinical evaluation of,as well as manifestations and prevention of adverse reactions to,cyclophosphamide alone or in combination with dexamethasone pulse therapy.