摘要
目的评估甲氨蝶呤（MTX）治疗轻、中度活动系统性红斑狼疮（SLE）的疗效。方法专科门诊随诊患者分为：A组，MTX加小剂量激素组（泼尼松10mg／d）28例；B组，中等剂量激素组（泼尼松30mg／d）20例，观察指标包括SLE疾病活动指数评分（SLEDAI）、激素减至少剂量维持治疗时病情复发情况及药物不良反应。结果A组积分由治疗前的（9．4±2．1）降至（4．1±0．9），B组由（8．6±2．5）降至（4.0±1．0）。两组治疗前后相比疗效差异显著（P〈0．01），但A、B两组间疗效差异无统计学意义（P〉0．25），激素减量至10mg／d维持后B组有8例出现病情反复，A组在总观察期有3例病情反复，两组对比差异有统计学意义（P〈0．025）。A组不良反应主要是胃肠道反应，B组以库兴综合征为主。结论MTX对轻中症SLE治疗有效，加用MTX可减少激素用量，防止长期使用偏大量激素引起相关不良反应。
Objective To investigate the curative effect of methotrexate in treating systemic lupus erythematosus（SLE）. Methods The chosen outpatients were divided into 2 groups,group A（28 cases） ：MTX combined with small dosage of prednisone （ prednisone 10mg/d） ; group B （ 20 cases） ： medium dosage of prednisone （ prednisone 30mg/d）. Observation includes SLE disease activity index （SLEDAI）, relapse while dosage of prednisone was reduced to small amount and drug side effects. Results The SLEDAI score of group A was reduced from （9.4 ± 2. 1 ） to （4. 1 ± 0.9 ）, and group B from （ 8.6 ± 2.5 ） to （4. 0 ± 1.0 ）. Compared the result of before and after treatment between the two groups, the curative effect is obvious （P 〈 0. 01 ）. However, there was no significant difference of efficacy between the two groups （ P 〉 0. 25 ）. While dosage of prednisone was reduced to 10mg/d, there were 8 cases of relapse in group B,and only 3 cases in group A during the entire observation period. The difference is significant （ P 〈 0. 025 ）. The side effect of group A is gastrointestinal reaction and for B is mainly the cushing syndrome. Conclusion MTX is an effective treatment fw the light and medium activity SLE, and can reduce the dose of prednisone, prevent long-term using large dose of prednisone which will cause side effect.
出处
《中国基层医药》
CAS
2009年第4期589-590,共2页
Chinese Journal of Primary Medicine and Pharmacy
关键词
红斑狼疮
系统性
甲氨蝶呤
泼尼松
Lupus erythematosus, systemic
Prednisone
Methotrexate
