中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
10期
904-906
,共3页
石哲群%沈春瑾%饶莉%邢桂芝%王志敏%许文静%冯静%佟胜全
石哲群%瀋春瑾%饒莉%邢桂芝%王誌敏%許文靜%馮靜%佟勝全
석철군%침춘근%요리%형계지%왕지민%허문정%풍정%동성전
系统性红斑狼疮%难治性蛋白尿%环磷酰胺%霉酚酸酯
繫統性紅斑狼瘡%難治性蛋白尿%環燐酰胺%黴酚痠酯
계통성홍반랑창%난치성단백뇨%배린선알%매분산지
Systemic lupus erythematosus%Refractory proteinuria%Cyclophosphamide%Mycophenolate mofetil
目的 探讨环磷酰胺(CTX)联合霉酚酸酯(MMF)治疗系统性红斑狼疮(SLE)难治性蛋白尿患者的临床疗效与不良反应.方法 选取确诊为系统性红斑狼疮并发难治性蛋白尿患者共计66例,随机分为A、B两组,每组均为33例.A组为糖皮质激素(GC)联合CTX治疗,B组为GC+CTX+MMF治疗.两组治疗期间其余治疗措施包括抗凝、降脂、控制血压及对症治疗等均基本相同.通过对临床指标包括尿蛋白、补体C3、抗dsDNA抗体、肝肾功能及月经变化等指标进行临床观察12个月.结果 B组治疗后在尿蛋白、补体C3、血肌酐(Scr)、尿红细胞及血清白蛋白[分别为(0.95±0.82) g/24 h、(0.75±0.23) g/L、(90.50±32.33) μmol/L、(42.52±10.93)个/μl、(37.6+7.82) g/L]较A组[分别为(3.10±1.08) g/24 h、(0.63±0.20) g/L、(120.20±40.90) μmol/L、(48.55±11.35)个/μl、(33.52±8.51) g/L]差异均有统计学意义(t值分别为9.77、2.72、3.27、2.20、2.04,P均＜0.05).结论 GC+CTX+ MMF治疗SLE难治性蛋白尿疗效显著,在治疗过程中均未出现严重不良反应.
目的 探討環燐酰胺(CTX)聯閤黴酚痠酯(MMF)治療繫統性紅斑狼瘡(SLE)難治性蛋白尿患者的臨床療效與不良反應.方法 選取確診為繫統性紅斑狼瘡併髮難治性蛋白尿患者共計66例,隨機分為A、B兩組,每組均為33例.A組為糖皮質激素(GC)聯閤CTX治療,B組為GC+CTX+MMF治療.兩組治療期間其餘治療措施包括抗凝、降脂、控製血壓及對癥治療等均基本相同.通過對臨床指標包括尿蛋白、補體C3、抗dsDNA抗體、肝腎功能及月經變化等指標進行臨床觀察12箇月.結果 B組治療後在尿蛋白、補體C3、血肌酐(Scr)、尿紅細胞及血清白蛋白[分彆為(0.95±0.82) g/24 h、(0.75±0.23) g/L、(90.50±32.33) μmol/L、(42.52±10.93)箇/μl、(37.6+7.82) g/L]較A組[分彆為(3.10±1.08) g/24 h、(0.63±0.20) g/L、(120.20±40.90) μmol/L、(48.55±11.35)箇/μl、(33.52±8.51) g/L]差異均有統計學意義(t值分彆為9.77、2.72、3.27、2.20、2.04,P均＜0.05).結論 GC+CTX+ MMF治療SLE難治性蛋白尿療效顯著,在治療過程中均未齣現嚴重不良反應.
목적 탐토배린선알(CTX)연합매분산지(MMF)치료계통성홍반랑창(SLE)난치성단백뇨환자적림상료효여불량반응.방법 선취학진위계통성홍반랑창병발난치성단백뇨환자공계66례,수궤분위A、B량조,매조균위33례.A조위당피질격소(GC)연합CTX치료,B조위GC+CTX+MMF치료.량조치료기간기여치료조시포괄항응、강지、공제혈압급대증치료등균기본상동.통과대림상지표포괄뇨단백、보체C3、항dsDNA항체、간신공능급월경변화등지표진행림상관찰12개월.결과 B조치료후재뇨단백、보체C3、혈기항(Scr)、뇨홍세포급혈청백단백[분별위(0.95±0.82) g/24 h、(0.75±0.23) g/L、(90.50±32.33) μmol/L、(42.52±10.93)개/μl、(37.6+7.82) g/L]교A조[분별위(3.10±1.08) g/24 h、(0.63±0.20) g/L、(120.20±40.90) μmol/L、(48.55±11.35)개/μl、(33.52±8.51) g/L]차이균유통계학의의(t치분별위9.77、2.72、3.27、2.20、2.04,P균＜0.05).결론 GC+CTX+ MMF치료SLE난치성단백뇨료효현저,재치료과정중균미출현엄중불량반응.
Objective Discuss the clinical effects and adverse reaction of cyclophosphamide (CTX) with mycophenolate mofetil(MMF) therapy to refractory proteinuria in systemic lupus erythematosus (SLE).Methods Sixty-six cases SLE patients were randomly divided them into Group A(33 cases) and Group B(33 cases).The patients in group A were given Glucocorticoids(GC) with CTX and in group B were given GC+CTX + MMF.Other treatments were basically the same, including anticoagulation, lipid-lowering, blood pressure control and other symptomatic treatments.Clinical indicators, including proteinuria, complement C3, anti-dsDNA antibodies ,liver and kidney function and menstrual changing were observed for 12 months.Results In group B, proteinuri, anti dsDNA antibody positive cases number, complement C3, serum creatinine(SCr), urine red blood cell and serum albumin a number of indicators ((0.95 ± 0.82) g/24 h, (0.75 ± 0.23) g/L, (90.50± 32.33) μmol/L, (42.52± 10.93) individual/μl, (37.6±7.82) g/L) were lower than those of in group A ((3.10 ± 1.08) g/24 h, (0.63 ± 0.20) g/L, (12.02 ± 40.90) μmol/L, (48.55 ± 11.35) individual/μl, (33.52 ±8.51) g/L) after treatment, and the differences were statistically significant(t =9.77,2.72,3.27,2.20,2.04;P＜0.05).Conclusion GC +CTX+MMF therapy shows an outstanding effect on refractory proteinuria in systemic lupus erythematosus.In addition, there is also no serious negative effect during the process of the treatments.
