毛晓玲 陈湛华 韦宏成 章俊 蔡启德 郑绮宜 毛晓玲 陈湛华 韦宏成 蔡启德 郑绮宜 510630 广州，暨南大学医学院第一附属医院肾内科；章俊 第一军医大学珠江医院肾内科 中华肾脏病杂志 1999 0 15 2


    关键词：狼疮肾炎；系统性红斑狼疮 期刊 zhszbzz 0 继发性肾小球疾病专题论著 fur -->


    

【摘要 】 目的 探讨狼疮肾炎的治疗目标。方法 32例狼疮肾炎患者进入研究，其中27例接受肾活检。治疗分为三期：(1)首始治疗期；(2)持续治疗期；(3)维持治疗期。制定数个等级的治疗缓解目标并追踪(48±10)月。结果 20/32例患者达完全缓解，Scr从(353±115)降至(110±76)μmol/L(P<0.001)，尿蛋白从(8.6±4.5)减少至(1.5+0.9)g/d(P<0.01)。9例复发(28.1%)。至追踪期末，有2例分别进入氮质血症期和尿毒症期。结论 狼疮肾炎的治疗目标是达到最大的治疗利益和最少药物副作用之间的平衡。要求达到实验室和临床的完全缓解是不现实的，应注意避免过度治疗带来的各种危险的副作用。

Research about the goals oftreatment of lupus nephritis

MAO Xiaoling,CHAN Zhanhua,WEIHongcheng,et al.Department of Nephrology, The First Affiliated Hospital of JinanUniversity Medical College, Guangzhou.510630

【Abstract 】 Objective Toclarify the goals of treatment of lupus nephritis.Methods 32 patientswith LN were studied.Renal biopsies were performed in 27/32 of them.Treatment wasstructured in 3 phase:(1)pulse treatment phase; (2)continuous treatmentphase;(3)maintenance treatment phase. Primary from several targets was geparated andpatients were followed up for 48±10 months.Results 20/32 patientsachieved remission of glomerulonephritis,the others partly remission. Serum creatininefell from (353±115) to(110±76)μmol/L(P<0.0001).Proteinuria decreased from(8.6±4)to(1.5±0.9)g/d(P<0.01). 9 patients relapsed (28.1%), 2 later progressed to azotemia andend-stage renal failure, respectively.Conclusion The goals of treatmentof lupus nephritis are aimed more at reaching a favourable balance between benefits andside-effects,The symptomatic control to the point of allowing a goal quality of life andan acceptable lifestyle rather than pursuing the healing or a complete well belling at thecost of more risky complications. It is unrealistic to pursue the full clinical andlaboratory regression of the disease.

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