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J Rheumatol:近年来增生性狼疮肾炎患者急性发作的长期数据

2017-07-03 xiangting MedSci原创

研究数据显示LN在更近一个时期内急性发作率更低,这归因于免疫抑制剂的有效诱导和使用MPA作为维持治疗。

这项研究旨在探讨近年来狼疮肾炎(LN)的急性发作率,重点是肾脏急性发作和与复发风险相关的因素。

研究人员分析了1983年1月至2013年12月诊断的139例III/IV±V级中国LN患者的数据。此外当维持免疫抑制剂从硫唑嘌呤(AZA)转变为麦考酚酸(MPA)时,研究人员还比较了1998年前后的数据。

在112.5±88.4个月中,发生135例肾脏急性发作,每患者年急性发作率为0.108。在诱导治疗开始后1,2,3,4,5和10年,肾脏无复发生存率分别为96%,90%,86%,80%,69%和57% 。急性发作风险降低与MPA维持(OR 0.314,95%CI 0.099-0.994,p = 0.049),诱导免疫抑制后完全缓解(OR 0.329,95%CI 0.133-0.810,p = 0.016),和1998年后诊断(OR 0.305,95%CI 0.133-0.700,p = 0.005)相关。与泼尼松龙和AZA相比(分别为70%和52%,p = 0.044),用泼尼松龙和MPA作为维持免疫抑制剂的患者无复发生存率显著更高(分别为5年91%,10年83%)。

研究数据显示LN在更近一个时期内急性发作率更低,这归因于免疫抑制剂的有效诱导和使用MPA作为维持治疗。

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    2017-07-05 villahu
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    2017-07-03 131****1460

    学习了受益匪浅。

    0

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