Donadio J V, Holley K E, Ferguson R H, Ilstrup D M
N Engl J Med. 1978 Nov 23;299(21):1151-5. doi: 10.1056/NEJM197811232992102.
To evaluate the effectiveness of cyclophosphamide in the treatment of lupus nephritis, we designed a prospective study of patients with diffuse proliferative lupus nephritis. Twenty-six patients received prednisone (average dose, 40 mg per day) and 24 combined prednisone (average dose, 29 mg per day) and cyclophosphamide (average dose, 107 mg per day) for six months. Thereafter, all patients received maintenance doses of prednisone. Most of the patients improved (84 per cent) after six months of initial treatment with either program. Early progression of disease, ending mainly in end-stage renal disease, was equally frequent in the two treatment groups in patients with already advanced disease. In a four-year follow-up study there was a higher incidence (P approximately 0.04) and average rate (P approximately 0.02) of clinical recurrence of nephritis in the group initially given only steroid than in the group initially given both drugs. However, the proportion of patients alive after four years with stable or improved renal function was similar in the two treatment groups.
为评估环磷酰胺治疗狼疮性肾炎的疗效，我们设计了一项针对弥漫性增殖性狼疮性肾炎患者的前瞻性研究。26例患者接受泼尼松（平均剂量为每日40毫克）治疗，24例患者联合使用泼尼松（平均剂量为每日29毫克）和环磷酰胺（平均剂量为每日107毫克）治疗，为期6个月。此后，所有患者均接受泼尼松维持剂量治疗。两种治疗方案初始治疗6个月后，大多数患者病情改善（84%）。在病情已进展至晚期的患者中，疾病早期进展（主要发展为终末期肾病）在两个治疗组中的发生率相同。在一项为期四年的随访研究中，最初仅接受类固醇治疗的组中肾炎临床复发的发生率（P约为0.04）和平均复发率（P约为0.02）高于最初接受两种药物治疗的组。然而，四年后肾功能稳定或改善的存活患者比例在两个治疗组中相似。
