Tervaert J W, Huitema M G, Hené R J, Sluiter W J, The T H, van der Hem G K, Kallenberg C G
Department of Internal Medicine, University Hospital, Groningen, The Netherlands.
Lancet. 1990 Sep 22;336(8717):709-11. doi: 10.1016/0140-6736(90)92205-v.
58 patients with biopsy-proven Wegener's granulomatosis (WG) were prospectively screened for clinical evidence of the disease 3-monthly, with antineutrophil cytoplasmic antibody (ANCA) measurements every month. Over 24 months, ANCA rose in 20 patients, 9 of whom were randomly assigned to receive combined 9 and 3 month courses of cyclophosphamide and prednisolone, respectively, at the time of ANCA rise; and 11 patients who were untreated except if there was a clinical relapse. 6 of 11 untreated patients relapsed within 3 months of ANCA rise. 3 of the remaining 5 patients relapsed after 3 months. There were no early or late relapses in patients randomised to treatment. Patients receiving no treatment at the time of ANCA rise took more cyclophosphamide and prednisolone than patients who were treated. Side-effects did not significantly differ between the two groups.
对58例经活检证实为韦格纳肉芽肿（WG）的患者进行前瞻性筛查，每3个月检查一次该疾病的临床证据，每月检测抗中性粒细胞胞浆抗体（ANCA）。在24个月的时间里，20例患者的ANCA水平升高，其中9例在ANCA升高时分别被随机分配接受9个月和3个月疗程的环磷酰胺和泼尼松龙联合治疗；11例患者除临床复发外未接受治疗。11例未治疗的患者中有6例在ANCA升高后3个月内复发。其余5例患者中有3例在3个月后复发。随机接受治疗的患者没有早期或晚期复发。ANCA升高时未接受治疗的患者比接受治疗的患者服用了更多的环磷酰胺和泼尼松龙。两组的副作用没有显著差异。
