Scott D G, Bacon P A
Am J Med. 1984 Mar;76(3):377-84. doi: 10.1016/0002-9343(84)90654-5.
Systemic vasculitis in rheumatoid arthritis shows similarities to polyarteritis nodosa and may require equally aggressive therapy. Forty-five patients with systemic rheumatoid vasculitis were studied during treatment with either cyclophosphamide plus methylprednisolone given by intermittent bolus intravenous injection (21 patients) or a variety of other more conventional drug regimens (24 patients). In this open study, the intravenous treatment group had more severe initial disease, a higher incidence of neuropathy, and more frequent evidence of necrotizing arteritis on biopsy than the other treatment group. Despite this, intravenous cyclophosphamide plus methylprednisolone resulted in more frequent healing of vasculitic lesions including leg ulcers and neuropathy, a lower incidence of relapse, fewer serious complications, and a lower mortality than did other treatments. Toxic effects were similar in both study groups. Intravenous cyclophosphamide plus methylprednisolone is a useful early treatment for systemic rheumatoid vasculitis.
类风湿关节炎中的系统性血管炎与结节性多动脉炎有相似之处，可能需要同样积极的治疗。对45例系统性类风湿血管炎患者进行了研究，其中21例患者接受环磷酰胺加甲泼尼龙间歇性大剂量静脉注射治疗，24例患者接受其他多种更传统的药物治疗方案。在这项开放性研究中，静脉治疗组的初始疾病更严重，神经病变发生率更高，活检显示坏死性动脉炎的证据比其他治疗组更频繁。尽管如此，与其他治疗相比，静脉注射环磷酰胺加甲泼尼龙使血管炎性病变（包括腿部溃疡和神经病变）的愈合更频繁，复发率更低，严重并发症更少，死亡率更低。两个研究组的毒性作用相似。静脉注射环磷酰胺加甲泼尼龙是系统性类风湿血管炎的一种有效的早期治疗方法。
