Abe T
2nd Department of Internal Medicine, Saitama Medical Center, Saitama Medical School.
Nihon Rinsho. 1994 Aug;52(8):2173-6.
Before corticosteroids were used in the treatment of the systemic necrotizing vasculitides of the polyarteritis nodosa, the disease almost always progressed with variable degree of fulminance leading to death. The use of corticosteroids improves the 5-year survival. The most dramatic break-through in the therapeutic approach to the vasculitides has been clinical experience with cyclophosphamides in treating Wegener's granulomatosis. With this therapeutic regimen, Wegener's granulomatosis can now be considered a curable disease, if treated early and appropriately with therapeutic regimen. These therapeutic strategy can be extended to that of polyarteritis nodosa group of vasculitides. Now, it is clear that cyclophosphamide, either alone or in combination with pre-existing corticosteroid therapy, can effect a dramatic response if instituted early in the course of the disease process. With the advent of deeper insight as to immuno-pathogenesis and pathophysiologic mechanism, the striking therapeutic success can be expected in near future.
在皮质类固醇用于治疗结节性多动脉炎的系统性坏死性血管炎之前,该病几乎总是以不同程度的暴发性进展,最终导致死亡。使用皮质类固醇可提高5年生存率。血管炎治疗方法中最显著的突破是环磷酰胺治疗韦格纳肉芽肿的临床经验。采用这种治疗方案,如果早期并适当地进行治疗,韦格纳肉芽肿现在可被视为一种可治愈的疾病。这些治疗策略可扩展至结节性多动脉炎组血管炎。现在很清楚,环磷酰胺单独使用或与现有的皮质类固醇疗法联合使用,如果在疾病进程早期开始使用,可产生显著疗效。随着对免疫发病机制和病理生理机制有了更深入的认识,预计在不久的将来会取得显著的治疗成功。