Belovezhdov N, Tsekova D, Dzherasi R, Gruev I, Kiperova B
Vutr Boles. 1982;21(5):25-34.
Combined corticosteroid, immunosuppressive and anticoagulant treatment was performed to 17 patients with various histological forms of collagenous glomerulonephritis, 14--with disseminated lupus erythematodes, 1--with periartheritis nodosa and 2--with Schönlein-Henoch disease. The immunosuppressive treatment was carried out for an average of 14.62 months, the corticosteroid treatment--an average of 17 months and the anticoagulant--18.12 months. In 6 patients the corticosteroid treatment was initiated with a pulse of 30 mg methylprednisolone in the course of 3-10 days, and in the rest of the patients--with an initial dose of 60 mg prednisolone. The anticoagulant treatment was, at first, carried out with heparin 30,000 U daily, and later with acenocoumarol and the immunosuppressive--with azathioprin--100 mg daily. The term of treatment and observation is from 6 to 63 months, an average of 25-82 months. The treatment was discontinued in eight patients. Very good effect (complete clinical and laboratory remission) was obtained in seven patients--41.18 per cent, good effect (clinical remission but incomplete laboratory) in 7 patients--41.18 per cent, one patient with no change--5.88 per cent. Two patients--11.76 per cent, died of the complications of the treatment. Grave complications resulting from the treatment were obtained in seven patients.
对17例不同组织学类型的胶原性肾小球肾炎患者、14例播散性红斑狼疮患者、1例结节性多动脉炎患者和2例过敏性紫癜患者进行了皮质类固醇、免疫抑制和抗凝联合治疗。免疫抑制治疗平均进行14.62个月,皮质类固醇治疗平均进行17个月,抗凝治疗平均进行18.12个月。6例患者开始皮质类固醇治疗时,在3 - 10天内静脉注射30mg甲泼尼龙,其余患者初始剂量为60mg泼尼松龙。抗凝治疗起初每天使用30000U肝素,后来使用醋硝香豆素;免疫抑制治疗使用硫唑嘌呤,每天100mg。治疗和观察期为6至63个月,平均25 - 82个月。8例患者停止治疗。7例患者(41.18%)取得非常好的效果(临床和实验室完全缓解),7例患者(41.18%)取得良好效果(临床缓解但实验室检查不完全缓解),1例患者无变化(5.88%)。2例患者(11.76%)死于治疗并发症。7例患者出现了严重的治疗并发症。