いちおう訳してみました。

14人のIP合併SSｃ患者にステロイドパルスとエンドキサンパルスを3-4週ごと、計6回行なっ
た。以降1年おきに肺機能テストをおこなった。治療後にSkin scoreは17から13に35％低下、
胸部CTも有意に改善、13人中12人でCT所見の改善または安定化が見ら
れた。治療後のフォローアップで（平均26ヶ月）で患者の2/3がDLCOの悪化が見られた
。この治療法はこれまで報告と同じくSSCのIPに有効であった。DLCOの悪化が、治
療効力の低下判定に有用なマーカーかもしれない。早期のこのようなAggressive　Therapyが
予後不良のSSｃ患者に有効と考えられる。

[2003年1月9日 21時2分25秒]

古谷先生、できたらabstractだけでなく、日本語で要約してください。

[2003年1月7日 20時15分6秒]

以下の論文を読みました。今までの論文より説得力がある結果のようです。もうすでに青山では
よくやってますが、特に発症してから短い症例では試みるべき治療法と思いました。

J Rheumatol 2002 Nov;29(11):2371-8 Related Articles, Links  

  
Systemic sclerosis and interstitial lung disease: a pilot study using pulse 
intravenous methylprednisolone and cyclophosphamide to assess the effect on 
high resolution computed tomography scan and lung function.

Griffiths B, Miles S, Moss H, Robertson R, Veale D, Emery P.

Department of Rheumatology, Freeman Hospital, Newcastle Upon Tyne, England. 
bridget.griffiths@ncl.ac.uk

OBJECTIVE: To document the effectiveness, including the longterm effect, of a 
course of intravenous (IV) pulses of methylprednisolone (MP) and 
cyclophosphamide (CYC) in patients with scleroderma (SSc) who had evidence of 
lung inflammation on high resolution computer tomographic (HRCT) scan of the 
chest. METHODS: Fourteen consecutive patients with SSc and lung involvement 
were treated with 6 pulses of IV MP (10 mg/kg) and IV CYC (15 mg/kg) given at 3-
4 weekly intervals. HRCT scans and lung function tests were performed at 
baseline and after the 6th pulse. Further lung function tests were repeated at 
12 months and annually thereafter. RESULTS: Modified Rodnan skin scores 
improved significantly by 35% from a median baseline score of 17 (IQR 14-26.5) 
to a posttreatment score of 13 (IQR 10.5-18.5; p = 0.0058). HRCT scan scores 
improved significantly (p = 0.04). Twelve of 13 patients experienced either 
improvement or stabilization of the HRCT score. Median DLCO and lung volumes 
remained stable during the first 12 months. After a median followup of 26 
months (IQR 19-43), 67% of patients experienced deterioration in DLCO. Median 
deterioration was 23% (IQR 44-0.6), with the median rate of deterioration of 
the predicted value of the DLCO/month being 0.87% (IQR 1.24-0.02). The 
treatment was safe and well tolerated. CONCLUSION: This IV regimen stabilized 
lung disease in patients with SSc. When treatment was stopped, or reduced in 
intensity, a deterioration in lung function occurred in the majority of 
patients. Rate of deterioration of DLCO may be a useful marker for determining 
the intensity of treatment. These findings have implications for treating lung 
disease and designing clinical trials in patients with SSc.

[2002年12月29日 14時11分5秒]