在中国狼肺炎患者中成功戒除葡萄糖皮质类药物:一个单一中心的经验
Xiaoyuan Li1, Ying Tan1, Feng Yu2
1Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University, Beijing, China; Key laboratory of Renal Disease, Ministry of Health of China; Key laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, PR China.
International immunopharmacology
|November 9, 2023
概括
在狼性炎 (LN) 中成功停用葡萄糖皮质类药物 (GC) 对缓解期的患者是可行的,尽管它需要漫长的戒断期和仔细的监测. 这项研究确定了GC戒断的预测因素,并证实没有出现爆发或病进展的风险增加.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 狼性炎 (LN) 管理通常涉及长期使用葡萄糖皮质类药物 (GC),与显著的副作用相关.
- 确定成功的GC戒断的预测因素对于优化患者的治疗结果和减少治疗负担至关重要.
研究的目的:
- 确定可以成功从GC治疗中撤回的LN患者的比例.
- 探索与GC戒断相关的临床和病理预测因素.
- 为了评估在停用GC后的结局.
主要方法:
- 这是一项长度队列研究,在20年内对365名LN患者进行了纵向队列研究.
- 收集的数据包括人口统计,临床表现,发病时的病理,爆发和GC戒断后的结果.
- 统计分析,包括多变量分析,用于识别预测因素.
主要成果:
- 只有5.8%的患者成功停止了GC治疗,平均需要7.5年.
- 摘取GC与发病时性综合征的发病率较低和抗dsDNA抗体的发病率较高有关.
- 发病时瘤综合征是无法实现的GC退出的一个独立风险因素.
- 在中位数34个月的随访期间,在GC撤销后的患者中没有观察到发作.
结论:
- 在持续缓解 (≥5年) 的LN患者中,在不增加爆发,末期病 (ESKD) 或死亡的风险的情况下,切断葡萄糖皮质类药物是可行的.
- 低剂量GC戒断是一个漫长的过程,需要长时间和仔细的监测.
相关概念视频
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
122
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
122
01:24Nephrotic Syndrome III : Nursing Management
17
Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
17