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本文报告10例难治性狼疮性肾炎进行全身淋巴系统放疗效果。难治性的标准是:①肾组织学检查表明近6个月内有85%以上的肾小球受累;②对强的松(≥0.5g/kg/d)或并用细胞毒制剂治疗3个月以上无效,持续性蛋白尿(≥2.5g/d)或血肌酐升高;或当强的松剂量降至<0.5mg/kg/d时蛋白尿复现,出现肾病综合征,血肌酐增高,再加大强的松剂量(≥0.5mg/kg/d),服1个月也无改善者。禁忌放疗的标准:①白细胞总数<3,000/mm~3;②血小板数<75,000/mm~3;③贫血或骨髓增生不良;④年龄<18岁;⑤过去3年期间曾接受6个月以上的烷基化物治疗者;⑥现时伴有急性或慢性感染者;⑦终末期肾小球病,血肌酐>4mg/dl或肌酐清除率<20ml/min
This article reports 10 cases of refractory lupus nephritis systemic lymphatic system radiotherapy. Refractory criteria are: ① renal histological examination showed that more than 85% of glomeruli involved in the past 6 months; ② prednisone (≥ 0.5g / kg / d) or combined with cytotoxic agents in the treatment of 3 Month or more invalid, persistent proteinuria (≥ 2.5g / d) or serum creatinine increased; or when the dose of prednisone dropped to <0.5mg / kg / d proteinuria recurrence, nephrotic syndrome, increased serum creatinine , Plus strong prednisone dose (≥ 0.5mg / kg / d), no improvement in 1 month. Taboo radiotherapy criteria: ① total white blood cell count <3,000 / mm ~ 3; ② platelet count <75,000 / mm ~ 3; ③ anemia or myelodysplasia; ④ age <18 years old; ⑤ over the past three years have been accepted for 6 months or more Alkylate treatment; ⑥ now associated with acute or chronic infection; ⑦ terminal glomerular disease, serum creatinine> 4mg / dl or creatinine clearance <20ml / min