Tateishi M, Taniguchi A, Moriguchi M, Hara M, Kashiwazaki S
Institute of Rheumatology, Tokyo women's Medical College.
Nihon Rinsho Meneki Gakkai Kaishi. 1997 Jun;20(3):152-8. doi: 10.2177/jsci.20.152.
We studied the efficacy of cyclophosphamide pulse therapy (CYP) for refractory rheumatic diseases except for lupus nephritis. Thirty-five patients were included in all, that is 9 patients with systemic lupus erythematosus (SLE), 10 with rheumatoid arthritis (RA), 7 with polymyositis/dermatomyositis (PM/DM), 2 with progressive systemic sclerosis (PSS), 2 with anti-phospholipid antibody syndrome (APS), 1 with mixed connective tissue disease (MCTD), 1 with juvenile rheumatoid arthritis (JRA), 1 with Behcet's disease (BD), 1 with Wegener's granulomatosis (WG) and 1 with allergic granulomatous angiitis (AGA). Moderate to marked improvement was noted in 4 patients with SLE (2 with CNS-lupus and 2 with vasculitis), 7 with RA (2 with interstitial pneumonia:IP, 2 with vasculitis and 2 with refractory arthritis), 4 with PM/DM (2 with IP and 2 with refractory myositis), 1 PSS with IP, 2 APS with thrombocytopenia, 1 JRA with vasculitis and BD with CNS disturbance. On the other hand, adverse reactions were observed in 9 out of 35 patients (25.8%). CYP should apply in the treatment for such refractory rheumatic diseases as CNS disturbance, vasculitis, IP and autoimmune thrombocytopenia.
我们研究了环磷酰胺脉冲疗法（CYP）对除狼疮性肾炎外的难治性风湿性疾病的疗效。总共纳入了35例患者，其中系统性红斑狼疮（SLE）9例、类风湿关节炎（RA）10例、多发性肌炎/皮肌炎（PM/DM）7例、进行性系统性硬化症（PSS）2例、抗磷脂抗体综合征（APS）2例、混合性结缔组织病（MCTD）1例、青少年类风湿关节炎（JRA）1例、白塞病（BD）1例、韦格纳肉芽肿（WG）1例以及变应性肉芽肿性血管炎（AGA）1例。4例SLE患者（2例中枢神经系统狼疮和2例血管炎患者）、7例RA患者（2例间质性肺炎：IP、2例血管炎和2例难治性关节炎患者）、4例PM/DM患者（2例IP和2例难治性肌炎患者）、1例合并IP的PSS患者、2例合并血小板减少症的APS患者、1例合并血管炎的JRA患者以及1例合并中枢神经系统障碍的BD患者出现中度至显著改善。另一方面，35例患者中有9例（25.8%）观察到不良反应。CYP应应用于治疗中枢神经系统障碍、血管炎、IP和自身免疫性血小板减少症等难治性风湿性疾病。
