摘要
目的:观察霉酚酸酯联合环磷酰胺治疗狼疮性肾炎疗效及对患者免疫功能的影响。方法 :选取我院收治的狼疮性肾炎患者84例,按治疗方案的不同分为对照组和观察组,各42例。对照组予以环磷酰胺(静脉冲击,1 g/次,1次/月)治疗,观察组在对照组的基础上给予霉酚酸酯(0.5 g,bid)治疗。比较两组实验室检查指标、系统性红斑狼疮疾病活动指数(SLEDAI)评分、T淋巴细胞亚群CD3^+、CD4^+、CD8^+等免疫功能指标水平、临床疗效以及不良反应。结果 :治疗后两组SLEDAI评分、24 h尿蛋白定量均低于治疗前,血清白蛋白(ALB)高于治疗前,差异有统计学意义(P <0.05);治疗后观察组SLEDAI评分、24 h尿蛋白定量显著低于对照组,ALB显著高于对照组,差异有统计学意义(P <0.05);治疗后,两组CD3^+、CD8^+均低于治疗前,CD4^+高于治疗前,差异有统计学意义(P <0.05);治疗后观察组CD3^+、CD8^+显著低于对照组,CD4^+显著高于对照组,差异有统计学意义(P <0.05);观察组总缓解率为95.24%,显著高于对照组的73.81%,差异有统计学意义(P <0.05);两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 :霉酚酸酯联合环磷酰胺治疗狼疮性肾炎疗效显著,可有效改善患者病情及免疫状态,且安全性较高。
Objective:To observe the efficacy of mycophenolate mofetil combined with cyclophosphamide in the treatment of lupus nephritis and its effect on immune function.Methods:84 patients with lupus nephritis admitted to our hospital were selected and divided into a control group and an observation group according to different treatment options,42 cases each.The patients in the control group were treated with cyclophosphamide(venous shock,1 g/time,once/month),and the patients in the observation group were treated with mycophenolate mofetil(0.5 g,bid)on the basis of the control group.The laboratory test indexes,systemic lupus erythematosus disease activity index(SLEDAI)scores,T lymphocyte subsets CD3^+,CD4^+,CD8^+and other immune function indexes,clinical efficacy and adverse reactions were compared between the two groups.Results:The SLEDAI scores and 24 h urine protein quantitation in the two groups after treatment were lower than those before treatment,while the level of serum albumin(ALB)was higher than that before treatment,with statistically significant differences(P<0.05).The SLEDAI scores and 24 h urine protein quantification after treatment in the observation group were significantly lower than those in the control group,while the level of ALB was significantly higher than that in the control group,with statistically significant differences(P<0.05).The levels of CD3^+and CD8^+in the two groups after treatment were lower than those before treatment,while the level of CD4^+was higher than that before treatment,with statistically significant differences(P<0.05).The levels of CD3^+and CD8^+after treatment in the observation group were significantly lower than those in the control group,while the level of CD4^+was significantly higher than that in the control group,with statistically significant differences(P<0.05).The total response rate in the observation group was 95.24%,which was significantly higher than 73.81%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Mycophenolate mofetil combined with cyclophosphamide has a significant curative effect on lupus nephritis,which can effectively improve patient’s condition and immune status,and has higher safety.
作者
魏艳林
夏楠楠
张伟峰
黄家树
任智娟
朱丽娟
张振山
杨磊
Wei Yan-lin;Xia Nan-nan;Zhang Wei-feng;Huang Jia-shu;Ren Zhi-juan;Zhu Li-juan;Zhang Zhen-shan;Yang Lei(Department of Rheumatology and Immunology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450007,China)
出处
《中国合理用药探索》
CAS
2019年第4期50-53,共4页
Chinese Journal of Rational Drug Use
关键词
霉酚酸酯
环磷酰胺
狼疮性肾炎
Mycophenolate Mofetil
Cyclophosphamide
Lupus Nephritis
