匹多莫德对系统性红斑狼疮感染的预防作用研究

Effect of Pidotimod on Infection in Patients with Systemic Lupus Erythematosus

目的观察早期应用匹多莫德对外周血淋巴细胞减少的系统性红斑狼疮(SLE)感染情况、淋巴细胞亚群和疾病活动度的影响。方法将SLE治疗过程中外周血淋巴细胞计数减少到0.5×109/L以下的患者随机分为干预组26例和对照组23例。干预组常规治疗时加用匹多莫德,对照组不加用匹多莫德,观察两组感染发生率,及对淋巴细胞亚群和SLE疾病活动度(SLEDAI-2000)的影响。结果干预组26例中发生感染6例,感染率23.08%,对照组23例中发生感染9例,感染率39.13%,差异有统计学意义(P<0.01)。干预组治疗后外周血淋巴细胞、CD3+T细胞比例、CD4+T细胞比例及CD4+/CD8+比值较对照组明显提高(P<0.05)。干预组对SLEDAI-2000改善有促进作用(P<0.01)。结论匹多莫德对继发淋巴细胞减少的系统性红斑狼疮感染有较好的预防作用,能有效调节患者细胞免疫及体液免疫功能,促进疾病活动缓解。

Objective To study the effect of pidotimod on infection and lymphocyte subsets in patients with systemic lupus erythematosus（SLE） accompanied by lymphopenia. Methods Patients with SLE and lymphopenia（≤0.5×109/L） were randomly assigned to intervention group and control group. The intervention group received pidotimod in addition to conventional therapy,while control group only received conventional therapy. The total infection rates,changes of lymphocyte subsets,and the disease activity（SLEDAI-2000） were observed in both groups. Results Six of 26 patients in intervention group（23.08%） and 9 of 23 patients in control group（39.13%） were detected with infection, with a significant difference（P〈0.01）. Peripheral blood lymphocytes,CD3＋T cell ratio,CD4＋T cell ratio,and CD4＋/CD8＋ ratio were significantly increased in intervention group（P〈0.01）. The disease activity（SLEDAI-2000）of patients with SLE in intervention group was significantly alleviated. Conclusion Pidotimod can prevent patients with SLE from secondary infection caused by lymphopenia through regulating cellular immunity and humoral immune dysfunction and slow down disease activity.