单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,徽省院,Anhui Provincial Hospital a,狼疮肾炎治疗指南,解析,安徽省立医院风湿免疫科汪国生,徽省院,1,I型LN治疗,徽省院,Anhui Provincial Hospital a,共识:首先以RAAS抑制剂治疗蛋白尿,差异,ACR:不需要1S治疗,EULAR:蛋白尿1q/24h,特别是有小球性血尿,低到中等口服激素25-0.5mg/kg川d,如有必要联合,AZAl-2mg/kg/d,KDIGO:蛋白尿3g/24h:激素或CN(和MCD),GEAS:显著蛋白尿-29/24h和/或肾功能恶化:激,素可到o.5mg/kg/d,可能加AZA或MMF治疗6-12月,I型LN治疗,2,概要,徽省院,Anhui Provincial Hospital a,6个LN指南解析,难治性LN治疗,指南,多靶点治疗,MSC移植,新月体LN,LN血管病变,LN血栓性微血管病,他克莫司是治疗LN的有效药物,概要,3,有关狼疮肾炎的国际指南鉴嘴院,pean Dialysis and Transplant Association 16l,ican College of R,USA,Adults,particularly those receiving care int the USA,des intervention s available in the,KDIGO:Kidney Disease:Imptoving Global Outcomes May 2019,Interational,ults and children/adolescents,ne disease group of the,March 2019,Spain,Spanish Society of Internal Med icine and Spanish,DWP Dutch Working Party an Systemic Lupus,March 2019,The Netherlands Not specified,Arthritis and Rheumatology,lanch 201,Rescarch Alliance IIl,有关狼疮肾炎的国际指南鉴嘴院,4,mV型LN(无新月体)浆徽省院,Anhui Provin,cial hospitals,共识:口服激素+CTX或MMF,诱导开始予,或不予3次MP冲击。,差异,激素,MP剂量范围250-10omg/d,MP使用根据联合MMF或CTX方案和严重性。,口服剂量o.5-1mg/kg/d,有时根据联合MP、MMF或,CTX,减量方案不清楚,mV型LN(无新月体)浆徽省院,5,狼疮肾炎治疗指南剖析课件,6,狼疮肾炎治疗指南剖析课件,7,狼疮肾炎治疗指南剖析课件,8,狼疮肾炎治疗指南剖析课件,9,狼疮肾炎治疗指南剖析课件,10,狼疮肾炎治疗指南剖析课件,11,狼疮肾炎治疗指南剖析课件,12,狼疮肾炎治疗指南剖析课件,13,狼疮肾炎治疗指南剖析课件,14,狼疮肾炎治疗指南剖析课件,15,狼疮肾炎治疗指南剖析课件,16,狼疮肾炎治疗指南剖析课件,17,狼疮肾炎治疗指南剖析课件,18,狼疮肾炎治疗指南剖析课件,19,狼疮肾炎治疗指南剖析课件,20,狼疮肾炎治疗指南剖析课件,21,狼疮肾炎治疗指南剖析课件,22,狼疮肾炎治疗指南剖析课件,23,狼疮肾炎治疗指南剖析课件,24,狼疮肾炎治疗指南剖析课件,25,狼疮肾炎治疗指南剖析课件,26,狼疮肾炎治疗指南剖析课件,27,狼疮肾炎治疗指南剖析课件,28,狼疮肾炎治疗指南剖析课件,29,狼疮肾炎治疗指南剖析课件,30,狼疮肾炎治疗指南剖析课件,31,狼疮肾炎治疗指南剖析课件,32,狼疮肾炎治疗指南剖析课件,33,狼疮肾炎治疗指南剖析课件,34,狼疮肾炎治疗指南剖析课件,35,狼疮肾炎治疗指南剖析课件,36,狼疮肾炎治疗指南剖析课件,37,狼疮肾炎治疗指南剖析课件,38,狼疮肾炎治疗指南剖析课件,39,狼疮肾炎治疗指南剖析课件,40,狼疮肾炎治疗指南剖析课件,41,狼疮肾炎治疗指南剖析课件,42,狼疮肾炎治疗指南剖析课件,43,狼疮肾炎治疗指南剖析课件,44,狼疮肾炎治疗指南剖析课件,45,狼疮肾炎治疗指南剖析课件,46,