羟氯喹治疗原发性干燥综合征的临床观察

Treatment of primary Sjogren's syndrome with hydroxychloroquine

目的探讨羟氯喹(HCQ)治疗原发性干燥综合征(PSS)的疗效和安全性。方法给予30例PSS患者HCQ治疗,用量400 mg/d,疗程6个月～2年。患者前、后的临床症状和实验室指标进行比较,观察药物不良反应。结果治疗6个月后,患者口干、眼干、关节痛等主观症状和血沉(ESR)、C反应蛋白(CRP)、IgG、Ig M等实验室指标,与治疗前比较有较明显改善(P<0.05);全部患者均未出现明显毒副反应。10例随访2年的患者未发现眼底和视网膜改变。结论羟氯喹可改善PSS患者口干、眼干、关节痛症状,降低ESR、CRP和免疫球蛋白。规范使用羟氯喹治疗PSS毒副作用小,有较好的安全性。

Objective To evaluate the efficacy and safety of hydroxychloroquine（HCQ） in the treatment of primary Sjogren＇s syndrome（PSS）.Methods 30 patients with PSS were treated with HCQ（400mg per day for 6-24 months）.The clinical symptoms and laboratory data before and after treatment with HCQ were analyzed,and adverse drug reactions were observed.Results Severity of xerostomia,keratoconjunctivitis sicca,joint pain and other subjective symptoms had obviously reduced and levels of erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,IgG,IgM and other laboratory parameters had significantly improved 6 months after treatment with HCQ（P0.05）.Obvious toxic side effects had not been observed among all patients.No changes to fundus and retina among all of 10 patients during 2-year follow-up.Conclusion Hydroxychloroquine may improve symptoms such as xerostomia,keratoconjunctivi-tis sicca and joint pain as well as levels of ESR,CRP and immunoglobulin.Minor toxic side effects and better safety have reflected the advantage of rationally prescription of hydroxychloroquine in the treatment of primary Sjogren＇s syndrome.