摘要:目的 观察肾脂肪囊内介入注射甲基强的松龙治疗难治性狼疮性肾炎(LN)的疗效和安全性。 方法 24例难治性LN病人，随机分成A、B两组，A组为治疗组，给予强的松0.5mg·kg -1 ·d -1 、环磷酰胺0.6～0.8g·月 -1 、及每周二、五两次双肾脂肪囊注射甲基强的松龙40mg，当天停服强的松。B组为对照组，治疗方法同A组，但只予以局麻未做肾脂肪囊注射，周二、五停服当天强的松，改为口服甲基强的松龙80mg，观察治疗前后血常规、血浆白蛋白、24h尿蛋白定量、血肌酐(SCr)、尿素氮(BUN)、血沉、补体C3，观察肾囊内注射的副作用与安全性。 结果 治疗1月后A组24h尿蛋白、SCr、BUN比治疗前、对照组明显降低，血浆白蛋白、C3明显升高，消化道症状、消化道出血表现明显减少，而未增加糖皮质激素的其它全身副作用。 结论 LN是全身与局部免疫炎性反应的结果，全身治疗基础上联合肾脂肪囊介入注射甲基强的松龙局部治疗难治性LN效果显著、安全、副作用少。

    关键词:肾脂肪囊;介入治疗;甲基强的松龙;难治性狼疮性肾炎

    Preliminary study on the intervention treatment of refractory lupus nephritis by injecting methylprednisolone into renal dispose capsule.

    WEI Feng，LIANG Zhuo-yuan，SHI Xiao-feng，et al.

    (Jiangmen Municipal Central Hospital，Jiangmen529000，Guangdong，P.R.China)

    Abstract:Objective To observe effect，side effect and safety of interventional injecting methylprednisolone into renal adipose capsule on refractory lupus nephritis(LN). Methods (1)24patients with refractory LN were randomly divided into two groups，the test group and control group.Test Group was treated by orally given prednisone0.5mg·kg -1 ·d -1 、Intravenous cyclophosphamide0.6～0.8g·m -1 and injecting methylprednisolone40mg into per renal adipose capsule on Tuesday and Friday when the prednisone was stopped.The control group was treated with the same method as that of the test group in addition to that local anesthesia was per-formed without injecting renal adipose capsule ......