摘要
目的探讨环磷酰胺冲击联合激素治疗系统性红斑狼疮患者的临床效果。方法选取2016年3月至2017年5月在我院治疗的系统性红斑狼疮患者66例,随机分为对照组和观察组,每组33例。对照组患者给予激素治疗;观察组患者在对照组治疗的基础上给予环磷酰胺冲击治疗,两组患者均治疗12个月。检测比较两组患者治疗前后的免疫功能,比较两组患者的临床疗效和不良反应发生情况。结果治疗1周后,两组患者C4、Ig M、Ig G、Ig A水平均显著改善(P <0. 05),观察组患者的改善情况优于对照组,差异有统计学意义(P <0. 05)。疗程结束后,观察组患者的治疗总有效率(93. 94%)显著高于对照组(75. 76%),差异有统计学意义(P <0. 05)。治疗过程中,两组患者的不良反应发生率比较差异无统计学意义(P> 0. 05)。结论环磷酰胺冲击联合激素治疗系统性红斑狼疮患者,可明显改善免疫功能,显著提高临床治疗效果,安全可靠。
Objective To investigate the clinical effects of cyclophosphamide shock combined with hormone therapy in patients with systemic lupus erythematosus. Methods 66 patients with systemic lupus erythematosus who were treated in our hospital from March 2016 to May 2017 were selected. They were randomly divided into control group and observation group,with 33 cases in each group. The control group were treated with hormone therapy,the observation group were given cyclophosphamide shock therapy on the basis of the control group. Both groups were treated for 12 months. The immune function was compared between the two groups before and after treatment. The clinical efficacy and adverse reactions of the two groups were compared. Results After1 week of treatment,the levels of C3,C4,Ig M,Ig G,and Ig A in the two groups were significantly improved( P < 0. 05). The improvement of the observation group was better than that of the control group,and the difference was statistically significant( P < 0. 05). At the end of the treatment period,the total effective rate of treatment in the observation group( 93. 94%) was significantly higher than that in the control group( 75. 76%),and the difference was statistically significant( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups during the treatment( P > 0. 05).Conclusion Cyclophosphamide shock combined with hormone therapy treat systemic lupus erythematosus patients can significantly improve whose immune function,clinical treatment,and it's safe and reliable.
引文
[1]杨岫岩.系统性红斑狼疮治疗进展[J].中国实用儿科杂志,2016,7(1):73-75.
[2]周珣.免疫学检验联合检测应用于系统性红斑狼疮诊断价值研究[J].临床和实验医学杂志,2015,14(1):48-51.
[3]俞宝田. 1982年美国风湿病学会新修订的系统性红斑狼疮分类标准[J].北京医学,1983,32(2):177.
[4]魏菊屏,郝殿晋,樊欣娜.羟氯喹联合小剂量阿司匹林及泼尼松治疗妊娠合并系统性红斑狼疮疗效分析[J].河北医药,2015,37(15):2297-2299.
[5]鱼强,刘岐焕,程范军,等.血液净化联合DNA免疫吸附治疗重症系统性红斑狼疮的效果[J].临床和实验医学杂志,2016,15(6):560-562.
[6]卢勤燕,蔡小燕,林小军,等.系统性红斑狼疮患者外周血维生素D水平及其临床意义[J].实用医学杂志,2015,31(7):1123-1125.
[7]向守宝,鲁巧云,张彩云.环磷酰胺联合泼尼松在系统性红斑狼疮治疗中的疗效及安全性分析[J].标记免疫分析与临床,2016,23(4):400-402.
[8]杨小兰.免疫吸附联合小剂量环磷酰胺及糖皮质激素治疗重症系统性红斑狼疮临床观察[J].内科,2015,10(5):659-661.
[9]孙锦霞,陈丽梅,朱剑霞,等.激素联合大剂量环磷酰胺冲击治疗狼疮肾炎70例的护理[J].中国乡村医药,2015,22(14):74-75.
[10]余旸弢,张红卫,马绮文,等. DNA免疫吸附联合环磷酰胺冲击治疗重症系统性红斑狼疮的临床观察[J].北方药学,2017,14(5):122-123.
[11]吴霞.环磷酰胺联合泼尼松在系统性红斑狼疮治疗中的疗效及安全性[J].中国现代药物应用,2017,4(8):12-14.