Aihara Y, Ibe M, Mitsuda T, Mori M, Shimizu C, Takahashi Y, Kuriyama T, Yokota S
Department of Pediatrics, Yokohama City University, School of Medicine.
Ryumachi. 1994 Feb;34(1):64-70.
Since oral steroid therapy was introduced for SLE, the long-term prognosis of the patients has been significantly improved. Adverse effects of the drug, however, are inevitable for these patients. The characteristic of the adverse effects especially for the child case is the suppression of linear growth. In order to prevent these undesirable effects and to improve their quality of life (QOL), we had introduced the methylprednisolone pulse therapy for SLE in children as both an initial and a relapse therapy. Although this therapy improved QOL of the patients significantly, there was little benefit for the growth disturbance. Then, we have introduced Mizoribine in addition to prednisolone (PSL) therapy for more than 18 months in three SLE children with lupus nephritis. In this trial, the combination therapy was effective for the decrease of urinary protein in one case, and for the reduction of a dosage of oral PSL in one case. In other case, MZR showed only partial immunosuppression. Thus, we concluded that there was a limitation with this combination therapy, however, it is one of the worthy therapy to be tried in SLE children with nephritis.
自从口服类固醇疗法被用于系统性红斑狼疮(SLE)的治疗以来,患者的长期预后有了显著改善。然而,对于这些患者来说,药物的不良反应是不可避免的。尤其是儿童患者,不良反应的特点是抑制线性生长。为了预防这些不良影响并提高他们的生活质量(QOL),我们将甲基强的松龙冲击疗法引入儿童SLE的初始治疗和复发治疗中。尽管这种疗法显著改善了患者的生活质量,但对生长发育障碍几乎没有益处。然后,我们对三名患有狼疮性肾炎的SLE儿童在泼尼松龙(PSL)治疗基础上加用咪唑立宾超过18个月。在该试验中,联合治疗对其中一例患者减少尿蛋白有效,对另一例患者减少口服PSL剂量有效。在另一例患者中,咪唑立宾仅表现出部分免疫抑制作用。因此,我们得出结论,这种联合治疗存在局限性,然而,它是值得在患有肾炎的SLE儿童中尝试的治疗方法之一。