摘要
狼疮肾炎的病理分型是临床诊治及预后判断的基础。狼疮肾炎的治疗策略与进展更是建立在不断累积的循证医学证据之上。增生性狼疮肾炎因其相对较差的预后而更受关注,其治疗强调序贯使用诱导与维持治疗。经济条件许可,可考虑把MMF与环磷酰胺一样作为活动性狼疮肾炎诱导治疗的一线选择用药,而其他新型免疫制剂的疗效尚缺乏足够证据。维持治疗目前推荐硫唑嘌呤或MMF。部分难治性狼疮肾炎可以尝试其他治疗方法,但疗效都不确定。
The histological classification of lupus nephritis is the basis of clinical diagnosis, treatment and prognostic evaluation. The therapeutic strategy and progress for patients with lupus nephritis have based on the accumulative evidences of the medicine. The focus has been on the treatment of proliferative lupus nephritis because of its relatively poorer prognosis. The treatment is emphasized to use induction and maintenance therapies sequentially. The first line drug of induction therapy for active lupus nephritis may substitute Mycophenolate Mofetil （MMF）for cyclophosphamide if economic status is allowed. The efficacy of novel immunosuppressive agents （e.g. leflunomide or rituximab） is still under investigation. Ejther azathioprine or MMF are currently recommended as the drugs of the maintenance therapy. Other therapeutic options can be selectively applied in some refractory cases, however, these efficacies remaine to be confirmed.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2007年第9期721-725,共5页
Journal of Clinical Pediatrics
关键词
狼疮肾炎
诊断
治疗
lupus nephritis
diagnosis
treatment
