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題名 | Long-Term Clinical Effects of Intermittent Intravenous Cyclophosphamide on Severe Lupus Nephritis=間歇性靜脈注射cyclophosphamide對嚴重型紅斑性狼瘡腎炎的長期臨床效應 |
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作者 | 吳冠勳; 林世強; 蔡銘哲; 周正成; 曹永魁; 江伯倫; Wu, Kuan-hsun; Lin, Shih-chiang; Tsai, Ming-jer; Chou, Chen-cheng; Tsau, Yong-kwei; Chiang, Bor-luen; |
期刊 | 微免與感染雜誌 |
出版日期 | 19980300 |
卷期 | 31:1 1998.03[民87.03] |
頁次 | 頁27-34 |
分類號 | 415.812 |
語文 | eng |
關鍵詞 | 嚴重型紅斑性狼瘡腎炎; 間歇性靜脈注射; Lupus nephritis; Intravenous cyclophosphamide therapy; |
中文摘要 | 本回溯性研究主要探討間歇性靜脈注射cyclophosphamide對嚴重型紅斑性狼瘡腎 炎的長期臨床效應,毒性及對腎臟組織病理的影響。依病患每天口服類固醇的劑量,補體C3 及C4,血清抗DNA抗體,腎磷酸肌甘廓清率,每日尿蛋白量,血清白蛋白,血色素,尿素氮, 磷酸肌甘和腎臟組織病理來加以評估並作統計分析。結果顯示間歇性靜脈注射 cyclophosphamide早在治療的第三個月即對每天口服類固醇的劑量,補體C3及C4,血清白 蛋白,血色素和腎磷酸肌甘廓清率產生有統計意義的改善,而且此情形繼續持續至24個月, 然而血清抗DNA抗體,每日尿蛋白量和尿素氮的改善情況變異性較大;磷酸肌甘在本研究中則 沒有任何有統計意義的改善。腎臟組織病理分析也顯示大部分病患獲得改善,由原本的Class IV病灶進步到Class Ⅱ。幸好治療的併發症都非常輕微而且停藥後即可恢復正常。雖然本研 究為一回溯性分析且缺乏良好的對照組,但結果顯示間歇性靜脈注射cyclophosphamide對嚴 重型紅斑性狼瘡腎炎是一種有效的治療方式。當然,更進一步的研究和臨床的長期追蹤將有 助於我們更了解此種治療的優劣。 |
英文摘要 | This long-term follow-up study evaluates the clinical efficacy, toxicity, and effects on renal histopathology of intravenous high dose cyclophosphamide (IVCY) therapy for severe active lupus nephritis patients. The clinical course and final outcome for each patient was evaluted by determining daily oral prednisolone dose. C3, C4, anti-dsDNA, Ccr, daily urine protein, serum albumin, hemoglobulin, blood urea nitrogen, creatinine and renal histopathology. This regimen resulted in significant improvement of daily prednisolone dosage, serum C3, C4, albumin, hemoglobulin and Ccr as early as the third month, and became further improved or stable through 24 months. The mean anti-dsDNA level, twenty-four-hour urine protein excretion, and serum urea nitrogen level showed statistical decrease at variable time course and there were no statistical changes in the serum creatinine level throughout this study. Renal biopsies were obtained in 10 out-of 11 patients at the beginning of treatment, and follow-up renal biopsies were performed in 7 out of 10 patients, and five patients showed improvement in histologic features and had predominent Class II. Even this was an retrospective and uncontrolled study, intermittent IVCY therapy seemed to be an effective regimen for severe lupus nephritis. However, further investigation and regular follow-up are necessary to elucidate the long-term effects and complications of IVCY therapy. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。