Análise dos indicadores de atividade da doença em pacientes com nefrite lúpica antes e após seis pulsos de ciclofosfamida
Palabras clave:
nefrite lupica, ciclofosfamida, indicadores de atividadeResumen
Introdução
A ciclofosfamida é atualmente uma das principais drogas citotóxicas para o tratamento da nefropatia lúpica, manifestação clínica de grande morbidade e mortalidade.
Objetivo
Avaliar os níveis da proteinúria de 24 horas em pacientes com Lupus Eritematoso Sistêmico, tratados com pulsos de ciclofosfamida, estabelecendo uma correlação com a hemoglobina, a velocidade de hemossedimentação, a creatinina e frações C3 e C4 do complemento.
Métodos
Foram analisados os prontuários de 29 pacientes antes e após seis pulsos mensais e consecutivos de ciclofosfamida, correlacionando os níveis da proteinúria de 24 horas, hemoglobina, velocidade de hemossedimentação, creatinina, C3 e C4.
Resultados
Observaram-se diminuição na proteinúria de 24 horas (p<O,01), aumento da hemoglobina (p < 0,01), diminuição da velocidade de hemossedimentação (p < 0,05) e elevação dos níveis de C3 (p<0,05) e C4 (p<0,05). Também foi encontrada correlação entre hemoglobina e velocidade de hemossedimentação (p<0,01), hemoglobina e C4 (p<0,05) e C3 e C4 (p<0,01).
Conclusão
Os parâmetros analisados e correlacionados apresentaram melhora significativa, sendo mais pronunciada na proteinúria e na hemoglobina. Este estudo retrospectivo demonstrou a ação da ciclofosfamida nos indicadores de atividade da doença, no Lúpus Eritematoso Sistêmico, e a correlação destes indicadores.
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