SLE SLE CTX MMF MTX LEF FK SLE mg /d 2 SLE 0. 5 ~ 1 mg kg - 1 d mg kg - 1 d ~ mg /d 3 d

Size: px

Start display at page:

Download "2014 09 24 09 2 SLE SLE CTX MMF MTX LEF FK506 8 2 2. 1 SLE 1 1 10 mg /d 2 SLE 0. 5 ~ 1 mg kg - 1 d - 1 3 1 mg kg - 1 d - 1 2 8 4 500 ~ 1 000 mg /d 3 d"

圳岑
7 years ago
Views:

1 ( 广东省药学会风湿免疫用药专家委员会 ) systemic lupus erythematosus SLE LN ~ /10 1 SLE 20 ~ 40 a SLE SLE 1 SLE SLE CTX * MMF CsA FK506 MTX LEF - * A SLE Belimumab anti- BAFF SLE * 2 1 SFDA SLE SLE 1 LN LN 玺玺 Lupus Nephritis LN 玺 SLE Thomson Healthcare MI- CROMEDEX LN 3 SLE 2010 SLE 1 4 SLE & 5 CTX Endoxan SLE * CTX SLE LN LN & 630

2 SLE SLE CTX MMF MTX LEF FK SLE mg /d 2 SLE 0. 5 ~ 1 mg kg - 1 d mg kg - 1 d ~ mg /d 3 d 5 ~ 30 d 2012 SLE 2 ACR LN 2 Ⅲ /ⅣLN 1 3 d C 0. 5 ~ 1 mg kg - 1 d LN 口服 CTX CTX SLE < NIH 10 mg /d CTX 0. 5 ~ 1. 0 g /m ~ 100 mg 3 ~ ~ l ~ ACR 9 CTX / CTX CTX 0. 5 g / KDIGO LN 4 2 Ⅲ ⅣLN 2 CTX 3 CTX 1. 0 ~ 1. 5 mg kg - 1 GIOP d mg /d 2 ~ 4 4 CTX 0. 2 g CTX SLE / 6 / CTX SLE CTX SLE SLE LN CTX 1 1 ~ 2 10% 0. 5 mg kg - 1 d CTX 2013 EULAR LN 2 CTX Ⅲ/ⅣLN 631

3 mg SLE CTX SLE MTX CTX CTX SLE MTX 7. 5 ~ 15 mg / CTX MTX CTX MTX SLE MTX 9 SFDA FDA MTX SLE MMF MMF MMF B 2 MTX MMF MTX Ⅲ/ⅣLN 24 MMF LN CTX CTX 2012 ACR LN KDIGO LN LN CTX 4 FK506 MMF 5-7 Ⅲ/ⅣLN LN MMF 7 10 FK506 LN ⅤLN > 3 g /24 6 CTX FK506 h 0. 5 mg kg - 1 d - 1 MMF A Thomson ClassⅡa ClassⅡb FK506 FK506 CsA 10 ~ 100 SLE Thomson Healthcare MICROMEDEX FK506 SLE CTX MMF LN FK ~ 6 mg /dfk506 MMF ACR CsA MMF MMF 2 g 3 C EULAR SLE 沙利度胺 SLE TNF-α IL-8 IL-12 MMF 8 MMF SLE 2010 Thomson Healthcare MICROMEDEX 1 MMF LN SLE MMF 1 ~ 2 11 g /d2 2 MMF 50 ~ 100 mg /d MMF 3 ~ 6 30 d 苯丁酸氮芥 30 ~ 180 d DNA V MTX 2008 EULAR ~ 0. 2 mg kg -1 d -1 8 ~ 12 SLE MTX 632

4 Thomson Health- care MICROMEDEX IVIG 0. 4 g kg - 1 d ~ 5 d 长春新碱 2. 4 RNA B 4 ~ 12 SLE B B 62% ~ 1. 4 mg m 2 w mg 4 1 LN CTX MMF SLE SLE Thomson Healthcare MICROMEDEX mg /m mg IVIG SLE CD20 / 2012 ACR ~ 120 min 2 SLE * ** Thomson mg / FDA mg 5 mg Thomson ClassⅡa Ⅱa - Category B Thomson Class Ⅱ b Class Ⅱb Category B / CTX 1. 0 ~ 1. 5 FDA CTX 50 mg mg kg - 1 d - 1 SLEThomson 150 mg /d ClassⅡa Ⅱb Category B 0. 5 g / 1 ~ 2 g /d2 FDA MMF g / LN Thomson g / ClassⅡa ClassⅡa Category B Thomson Class Ⅱa ClassⅡa Category B 633

5 2 / 2. 5 mg / 7. 5 ~ 15 mg / FDA MTX / 5 mg SLEThomson 0. 1 g 1 g Class Ⅱa Class Ⅱb 5 mg /1 ml 10 mg / 1 ml 50 mg /5 ml 0. 5 g /5 ml 1 g /10 Category B ml 5 g /50 ml 0. 5 mg / 3 ~ 6 mg /d FDA SLE MICROMEDEX SLE 25 mg / 50 ~ 100 mg /d FDA LEThomson Class Ⅱa Class Ⅱb Category B mg / 0. 1 ~ 0. 2 mg 3. kg - 1 d ~ 12 FDA SLE MICROMEDEX SLE 1 mg ~ 1. 4 mg m 2 MICROMEDEX w - 1 SLE 2 mg ClassⅡ b Class Ⅱb Category C FDA g /10 ml 1 g / 0. 4 g kg - 1 d - 1 FDA X 20 ml g /25 3 ~ SLEThomson ml 2. 5 g /50 ml 5 G 2. g /100 ml 10 g /200 5 d 1 Class Ⅱb Class Ⅱb Category B ml IgG 5% mg /10 ml 375 mg /m 2 FDA B C 500 mg /50 ml 1 D B mg 2 SLE Thomson CD20 Ⅲ ~ Ⅳ CVP 8 3. CD20 B DLBCL CHOP 8 1 Class Ⅱb Class Ⅱb Category B Thomson Class Ⅱa Class Ⅱ b Category B SLE * ** Thomson Healthcare MICROMEDEX 634

6 附 : 关于依据等级的说明 SFDA Category A 2 Category B 3 Thomson 4 Category C 3 No Evidence 5 4 A 5 B C J Hahn BHMcMahon MAWilkinson Aet al. American College of Rheumatology guidelines for screeningtreatmentand management of lupus nephritisj. Arthritis Class Ⅰ Effective Care Res Hoboken ClassII a 3Duru Nvan der Goes MCJacobs JWet al. EULAR Evidence Favors evidence-based and consensus-based recommendations on Efficacy the management of medium to high-dose glucocorticoid therapy in rheumatic diseases J. Ann Rheum Dis ClassⅡ b Evidence is Inconclusive Glomerulonephritis Work Group. KDIGO Clinical Practice 4Kidney Disease Improving Global Outcomes KDIGO Guideline for Glomerulonephritis J. Kidney Inter Suppl ClassⅢ Ineffective 5Dooley MAHogan SJennette Cet al. Cyclophosphamide therapy for lupus nephritis poor renal survival in black AmericansJ. Glomerular Disease Collaborative Network. Kidney Int Appel GBContreras GDooley MAet al. Mycophenolate mofetil versus cyclophosphamide for induction treat- ment of lupus nephritis J. J Am Soc Nephrol 2009 Class I Recommended Isenberg DAppel GBContreras Get al. Influence of ClassⅡ a race /ethnicity on response to lupus nephritis treatment Recommended In Most the ALMS study J. Rheumatology Oxford ClassⅡb Recommended 8Bertsias G Ioannidis JPBoletis J et al. EULAR recommendations In Some for the management of systemic lupus erythe- matosus. Report of a Task Force of the EULAR Standing ClassⅢ Committee for International Clinical Studies Including Not Recommended Therapeutics J. Ann Rheum Dis Class Indeterminate

7 9Schiff MHJaffe JSFreundlich B. Head-to-headrandomisedcrossover study of oral versus subcutaneous methotrexate in patients with rheumatoid arthritis drug-exposure limitations of oral methotrexate at doses 15 mg may be overcome with subcutaneous administration J. Ann Rheum Dis Chen WTang XLiu Qet al. Short-term outcomes of induction therapy with tacrolimus versus cyclophosphamide for active lupus nephritis A multicenter randomized clinical trial J. Am J Kidney Dis Privette EDWerth VP. Update on pathogenesis and treatment of CLE J. Curr Opin Rheumatol Mok CC. Therapeutic options for resistant lupus nephritis J. Semin Arthritis Rheum J van Vollenhoven RFParodis ILevitsky A. Biologics in SLE towards new approachesj. Best Pract Res Clin Rheumatol

绪论疾病概论

绪论疾病概论新疆医科大学教案首页编号 :02 课程名称病理生理学专业临床医学口腔医学基础医学医学影像麻醉医学医学检验临床药学专业层次本硕和本科主讲老师克拉拉阿巴斯计划时数 3 班级 2010 级各班专业技术职称病理生理学教授编写时