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动物实验及临床研究均已证实肾组织淋巴及单核细胞浸润在新月体肾炎的发病机理中扮演重要角色。我们就12例运用大剂量甲基强的松龙冲击合并环磷酰胺静脉疗法(MP+CTX)治疗的新月体肾炎患者,对肾组织浸润的CD4、CD8、CD68及PCNA~+细胞进行动态观察,并就它们与疗效间的关系进行初步探讨。 一、材料与方法 1.病例选择:12例1990年～1995年间本科住院患者,男性3例,女性9例,年龄10～60岁,平均35岁,平均病程13.5个月。所有患者经肾活检确诊为新月体肾炎(新月体占肾活检肾小球数的50％以上),运用MP1.0g/d连续静滴三日,加用CTX0.75～1.0g.m~(-2)/月,静脉治疗4～12周后行重复肾活检,其中免疫复合物型7例(包括4例狼疮性肾炎,1例IgA肾炎,特发性2例),寡免疫复合物型5例(包括微型多发性动脉炎2例,结节性多动脉炎1例,特发性2例)。
Animal experiments and clinical studies have confirmed that renal tissue infiltration of lymphocytes and monocytes in the pathogenesis of crescentic glomerulonephritis play an important role. We conducted 12 cases of crescentic glomerulonephritis patients treated with high-dose methylprednisolone pulse combined with cyclophosphamide intravenous therapy (MP + CTX) to dynamically infiltrate the infiltrating CD4, CD8, CD68 and PCNA ~ + cells in renal tissue Observation, and the relationship between them and the efficacy of a preliminary study. First, materials and methods 1. Case selection: 12 cases of 1990 to 1995 undergraduate hospitalization, 3 males and 9 females, aged 10 to 60 years, mean 35 years, the average duration of 13.5 months. All patients were diagnosed as crescentic nephritis by renal biopsy (crescent accounted for more than 50% of the number of glomeruli of renal biopsy), MP1.0g / d continuous intravenous infusion of three days, plus CTX0.75 ~ 1.0gm ~ ( -2) / month, intravenous treatment of 4 to 12 weeks after repeated renal biopsy, including immune complexes in 7 cases (including 4 cases of lupus nephritis, IgA nephritis in one case, idiopathic 2 cases), oligo-immune complex type in 5 cases (Including 2 cases of micro-multiple arteritis, 1 case of polyarteritis nodosa, 2 cases of idiopathic).