Friday, July 27, 2012
Lupus nephritis patients how to use hormones and cyclophosphamide
Lupus nephritis patients how to use hormones and cyclophosphamide "issues of concern are the majority of patients, Shijiazhuang kidney disease hospital for a brief introduction of lupus nephritis patients how to use hormones and cyclophosphamide
The traditional drug treatment of lupus nephritis is a hormone, but in recent years, clinical practice shows that, with cytotoxic therapy, especially for intermittent pulse therapy with cyclophosphamide than a simple hormone by the efficacy is much better. Therefore, the treatment of lupus nephritis, cyclophosphamide plus hormones, rather than simply use the hormone. Hormones: (1) The general use of prednisone, the first beginning stages of treatment, adult 1mg/kg, daily morning Dayton clothing, until eight weeks after the reduction, a week less 5mg, small doses (the next day morning 1mg / kg) to the next day morning serving Dayton, continued treatment according to the specific circumstances of the period of time, to continue reduction effect than ideal, until the maintenance dose (the next day morning 0.4mg/kg). Some people think that lupus nephritis patients should be taking hormones for the rest of their lives, the general dosage for prednisone every other day for the morning service 10 20mg. It is noteworthy that the first start of the hormone dose should be enough, inadequate dosage (<30mg / d) is often ineffective, glomerular lesions will continue to progress into fibrosis and lead to irreversible renal failure. The condition is particularly serious or fulminant by high fever up to 40 ° C to a widespread rash and purpura, massive proteinuria, can also be used a large dose steroid pulse therapy. If the unconditional use of methylprednisolone and dexamethasone 150mg / d instead, the effect is also good. Cyclophosphamide (2): can inhibit the activity of lupus nephritis, stabilize the course of the disease, reduce the dosage of hormone, but also inhibit the effect of specific antibody, in particular, the elimination of the non-specific inflammation of lupus nephritis and T lymphocyte-mediated immune also good effect. Studies have shown that cyclophosphamide pulse therapy compared with continued drug use better efficacy and fewer side effects. Each 0.75 1.0g/m2 body surface area, intravenous infusion of foreign use of cyclophosphamide, the impact of 1 to 3 months 1 dose oral prednisone. Improved domestic cyclophosphamide pulse therapy, please refer to the aforementioned content.