Wetzels J F M
Department of Medicine, University Medical Centre St Radboud, Nijmegen, the Netherlands.
Neth J Med. 2004 Nov;62(10):347-52.
For patients with lupus nephritis, a 24-month course of intravenous cyclophosphamide has been advocated as the 'golden' standard of therapy. This regimen is associated with a high risk of persistent amenorrhoea in women or azoospermia in men. The risk of infertility is thus an important issue when discussing treatment options in patients with SLE. In this article I have summarised the information on cyclophosphamide-induced gonadal toxicity. In addition a brief overview is given of the literature on treatment of lupus nephritis. The data indicate that there is no hard evidence to support the superiority of long-term i.v. cyclophosphamide. Therefore, patients with SLE and the wish to have a baby should not be primarily treated with such a regimen.
对于狼疮性肾炎患者，静脉注射环磷酰胺进行为期24个月的疗程一直被推崇为治疗的“金标准”。该治疗方案会使女性出现持续性闭经或男性出现无精子症的风险较高。因此，在讨论系统性红斑狼疮患者的治疗方案时，不孕风险是一个重要问题。在本文中，我总结了关于环磷酰胺所致性腺毒性的信息。此外，还简要概述了狼疮性肾炎的治疗文献。数据表明，没有确凿证据支持长期静脉注射环磷酰胺具有优越性。因此，患有系统性红斑狼疮且希望生育的患者不应首先采用这种治疗方案。
