摘要
目的 探究甲氨蝶呤联合甲泼尼龙琥珀酸钠治疗活动期系统性红斑狼疮(SLE)的治疗效果,以及对活动性指标的影响。方法 选择2015年1月—2020年1月在本院治疗的75例活动期SLE患者作为研究对象。对照组使用甲泼尼龙琥珀酸钠。观察组在对照组的基础上,使用甲氨蝶呤注射液。使用SLE活动性指数(SLEDAI)计分表评估患者病情活动度。治疗3个月后评估所有患者整体治疗效果,分为临床缓解、显效、有效、无效。在治疗前后检测血沉(ESR)、C-反应蛋白(CRP)、补体C3、C4、ds-DNA抗体,以及进行24 h尿蛋白定量。结果 治疗3个月后2组整体疗效差异有统计学意义(Z=-3.056,P=0. 025),观察组整体疗效更佳;治疗第1个月、第3个月2组患者相关指标均明显好转,与入院第1天相比,差异均有统计学意义(P <0. 05);观察组在第1个月、第3个月血沉、CRP、ds-DNA抗体、24 h尿蛋白定量水平明显低于对照组(P <0. 05);观察组C3、C4明显高于对照组(P <0. 05)。结论 甲氨蝶呤和甲泼尼龙琥珀酸钠联合治疗活动期SLE是安全有效的,能在短时间内控制病情发展,改善与活动度相关的实验室指标,值得临床推广。
Objective To explore the therapeutic effect of methotrexate combined with methylprednisolone in the treatment of systemic lupus erythematosus(SLE)during active phase,and its effect on active indexes.Methods Seventy-five active SLE patients treated in our hospital from January 2015 to January 2020 were selected as the research subjects.The control group used methylprednisolone.The observation group used methotrexate injection on the basis of the control group.We used the SLE Activity Index(SLEDAI)score table to evaluate the patient's disease activity.After 3 months of treatment,the overall treatment effects of all patients were evaluated and expressed as clinical remission,marked effect,effective,and ineffective.Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),complement C3,C4,ds-DNA antibodies,and 24-hour urine protein quantification were measured before and after treatment.Results After 3 months of treatment,the difference in overall efficacy between the two groups was statistically significant(Z=-3.056,P=0.025),and the overall efficacy of the observation group was better;the relevant indicators of the two groups of patients were significantly improved at the first and third months of treatment.Compared with the first day of admission,the difference was statistically significant(P<0.05);the observation group had erythrocyte sedimentation rate,CRP,ds-DNA antibody at month 1 and month 3.The 24 h urine protein level was significantly lower than the control group(P<0.05);the former C3,C4 were significantly higher than the later(P<0.05).Conclusion The combined treatment of methotrexate and prednisolone in the active period of SLE is safe and effective.It can control the development of the disease in a short time and improve the laboratory indicators related to the degree of activity.It is worthy of clinical promotion.
作者
张华燕
何援军
ZHANG Hua-yan;HE Yuan-jun(Department of Rheumatology and Nephrology,Zhejiang Quhua Hospital,Quzhou,Zhejiang 324000,China)
出处
《中国卫生检验杂志》
CAS
2021年第19期2357-2359,2363,共4页
Chinese Journal of Health Laboratory Technology
基金
2018年度衢州市科技计划指导性项目(第二批)(201-8127)。
