Barron K S, Person D A, Brewer E J, Beale M G, Robson A M
J Pediatr. 1982 Jul;101(1):137-41. doi: 10.1016/s0022-3476(82)80203-5.
The prognosis of patients with diffuse proliferative lupus nephritis is generally poor, and the majority of patients with this lesion develop progressive deterioration in renal function. Intravenous "pulses" of methylprednisolone have been advocated for the treatment of severe nephritis. In this study, 15 patients with biopsy-proven diffuse proliferative lupus nephritis were treated with oral high-dose prednisone therapy, initially 2 mg/kg/day. They were compared with seven patients with similar renal pathology treated with six daily pulses of methylprednisolone (30 mg/kg/day, not to exceed 1 gm/day), followed by prednisone orally, initially 2 mg/kg/day. There were no deaths in either group and the side effects of therapy were similar in the two groups. Pretreatment GFRs for the pulse and high-dose groups were similar. There was a more rapid improvement in GFR following pulse therapy, but the long-term effects on renal function for the two modes of therapy were the same.
弥漫性增殖性狼疮性肾炎患者的预后通常较差，大多数患有这种病变的患者会出现肾功能进行性恶化。静脉注射甲基强的松龙“冲击疗法”已被提倡用于治疗重症肾炎。在本研究中，15例经活检证实为弥漫性增殖性狼疮性肾炎的患者接受了口服大剂量泼尼松治疗，初始剂量为2mg/kg/天。将他们与7例具有相似肾脏病理的患者进行比较，后者接受了6次甲基强的松龙每日冲击治疗（30mg/kg/天，不超过1g/天），随后口服泼尼松，初始剂量为2mg/kg/天。两组均无死亡病例，且两组治疗的副作用相似。冲击治疗组和大剂量治疗组的治疗前肾小球滤过率（GFR）相似。冲击治疗后GFR改善更快，但两种治疗方式对肾功能的长期影响相同。
