本刊首页 > 期刊目次 > 血浆置换联合小剂量环磷酰胺、糖皮质激素治疗重型系统性红斑狼疮的临床效果

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血浆置换联合小剂量环磷酰胺、糖皮质激素治疗重型系统性红斑狼疮的临床效果

  • 霍爱鑫

* 通信作者: 霍爱鑫, 单位:延安大学附属医院 716000

摘要


目的 探讨血浆置换联合小剂量环磷酰胺(CTX)、糖皮质激素治疗重型系统性红斑狼疮(SLE)的疗效;

方法 选取2012年1月2015年3月在延安大学附属医院住院治疗的67例重型SLE患者,并将其随机分为研究组(33人)和对照组(34人),研究组治疗方案:糖皮质激素+血浆置换+环磷酰胺(诱导期:环磷酰胺(CTX)400mg 静滴 每2周一次,共6次;维持期:CTX 400mg 静滴 每月一次,两期共8.0g)。对照组治疗方案:糖皮质激素+ CTX(诱导期:CTX 800mg 静滴 每5天1次,共6次,维持期:CTX 800mg 每3月一次,两期总量共8.0g)。比较两组患者治疗前后狼疮疾病活动指数(SLEDAI)、补体C4、抗dsDNA抗体、红细胞沉降率(ESR)、C反应蛋白(CRP)的变化、及临床症状的改善情况。

结果:治疗后研究组临床改善率要高于对照组,差异有统计学意义(P<0.05);治疗后1月、3月、1年,研究组患者的SLEDAI、补体C4、抗dsDNA抗体、ESR、CRP较对照组下降更明显,差异有统计学意义(P<0.05);研究组发生副作用的人数为7人(21.2%),对照组发生副作用的人数为18人(52.9%),差异有统计学意义(P<0.05),对照组的副作用发生率要高于研究组。

结论 血浆置换联合小剂量CTX、糖皮质激素治疗重型SLE的临床效果显著,值得进一步临床推广使用。

关键词: [关键词] 血浆置换;甲氨蝶呤;糖皮质激素;系统性红斑狼疮

ABSTRACT

[Abstract]
Objective :To explore the Efficacy of Plasma exchange combined with small dose of cyclophosphamide and glucocorticoid in thetreatment of severe systemic lupus erythematosus(SLE).

Methods :from January 2012 to March 2015 , Affiliated Hospital of Yan'an University, 67 cases of severe SLE patients were randomly divided into study group (33 people) and control group (34 people).Patients in the observation group was given low dose cyclophosphamide and glucocorticoid treatment based on the use of Plasma exchange(induction period: 400mg cyclophosphamide for each of the 2 Monday times, a total of 6 times; maintenance period: Cyclophosphamide 400mg intravenous drip once a month, two 8.0g). SLEDAI, C4, dsDNA antibody, ESR, CRP, and the improvement of clinical symptoms were compared before and after treatment .

Results: the observation group clinical improvement rate was higher than that of the control group, the difference was statistically significant (P<0.05); After one year,the study group of patients with SLEDAI, complement C4, dsDNA antibody, ESR, CRP compared with the control group decreased more significantly, the difference was statistically significant (P<0.05); the adverse event occurred were 7 cases in the observation group, and 18 cases of adverse event occurred in the the control group,difference was statistically significant (P<0.05).

Conclusion  : Plasma exchange combined with small dose of cyclophosphamide and glucocorticoid in thetreatment of severe systemic lupus erythematosus can significantly improve the treatment effect.

Key words: Keywords:Plasma exchange;Glucocorticoid;Cyclophosphamide;Systemic lupus erythematosus

引用本文 / How to Cite This Article

霍爱鑫.血浆置换联合小剂量环磷酰胺、糖皮质激素治疗重型系统性红斑狼疮的临床效果[J]. 国际精神病学杂志, , (): -

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