Steinberg A D, Steinberg S C
Arthritis and Rheumatism Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland 20892.
Arthritis Rheum. 1991 Aug;34(8):945-50. doi: 10.1002/art.1780340803.
The purpose of this study was to assess long-term preservation of renal function in 111 patients with systemic lupus erythematosus and active glomerulonephritis who participated in a randomized treatment trial. Four different drug treatment programs, each of which allowed the use of low-dose oral prednisone in addition to the study drug(s), were compared with a regimen consisting solely of high-dose oral prednisone. Patients randomized to receive intravenous cyclophosphamide, oral cyclophosphamide, or oral azathioprine plus cyclophosphamide had significantly better preservation of renal function than did patients who were randomized to receive prednisone only. Results in the azathioprine group did not differ from those in the prednisone-only group. Cyclophosphamide appears to have long-term benefit in the delay or prevention of end-stage renal disease in patients with lupus nephritis.
本研究的目的是评估111例系统性红斑狼疮伴活动性肾小球肾炎患者参与一项随机治疗试验后的肾功能长期保存情况。将四种不同的药物治疗方案（每种方案除研究药物外均允许使用低剂量口服泼尼松）与仅由高剂量口服泼尼松组成的治疗方案进行比较。随机接受静脉注射环磷酰胺、口服环磷酰胺或口服硫唑嘌呤加环磷酰胺的患者，其肾功能保存情况明显优于随机仅接受泼尼松治疗的患者。硫唑嘌呤组的结果与仅接受泼尼松治疗组的结果无差异。环磷酰胺似乎对狼疮性肾炎患者延缓或预防终末期肾病具有长期益处。
