甲基泼尼松龙联合环磷酰胺治疗对SLE患者细胞因子、免疫球蛋白、补体水平的影响及疗效分析

Study of methylprednisolone combined with cyclophosphamide therapy on systemic lupus erythematosus patients with cell factor,immunoglobulin,complement levels

目的探讨甲基泼尼松龙联合环磷酰胺治疗对系统性红斑狼疮患者细胞因子、免疫球蛋白、补体水平的影响及其疗效研究。方法选择该院于2014年5月至2016年5月收治的系统性红斑狼疮患者92例,分成对照组(46例)与观察组(46例)。对照组给予甲基泼尼松龙进行治疗,观察组在对照组的基础上加用环磷酰胺进行治疗,两组均以90d为1个疗程。观察并记录治疗前后两组患者血清单核细胞趋化蛋白-4(MCP-4),白细胞介素-4(IL-4),白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),免疫球蛋白A、G、M(IgA、IgG、IgM),抗双链DNA抗体(抗ds-DNA抗体),以及补体C3、C4水平的变化情况,同时对比两组患者的临床疗效。结果治疗1个疗程后两组患者细胞因子MCP-4、IL-4、IL-6、TNF-α,免疫球蛋白IgA、IgG、IgM及抗ds-DNA抗体,补体C3、C4水平均明显改善,且观察组的上述指标水平均明显优于对照组,差异均有统计学意义(P<0.05);观察组的治疗总有效率为93.5%,明显高于对照组的76.1%,差异有统计学意义(P<0.05)。结论甲基泼尼松龙联合环磷酰胺治疗能够明显改善系统性红斑狼疮患者血清细胞因子、免疫球蛋白及补体水平,且疗效显著,值得临床推广应用。

Objective To investigate the effect of treatment of systemic lupus erythematosus patients its effect. Methods 92 patients with systemic lupus May 2016 were randomly divided into control group group was given methylprednisolone treatment, and was treated with cyclophosphamide, two groups were methylprednisolone combined with cyclophosphamide on with cell factor, immunoglobulin, complement levels and erythematosus（SLE） in our hospital from May 2014 to （n=46） and observation group （n=46）. The control the observation group on the basis of the control group in 90 d for a course of treatment. Observe and record the two groups before and after treatment of serum monocyte chemoattractant protein-4 （MCP-4）,interleukin-4 （IL-4） ,interleukin-6 （IL-6） ,tumor necrosis factor-α （TNF-α） ,immunoglobulin A,G,M （IgA,IgG,IgM） ,an- ti-double stranded DNA antibody （anti-ds-DNA antibody）,and the change of complement C3,C4 level,and compared the clinical efficacy of the two groups. Results After treatment of two groups of patients,IL-4 cyto- kines MCP-4, IL-6, TNF-α, immunoglobuIin IgA, IgG, IgM and anti-ds-DNA antibodies, complement C3 and C4 levels were significantly improved,and the indexes of the observation group were significantly better than those of the control group, the differences were statistically significant （P^0.05）~After treatment the total effective rate,in the observation group （93.5%） was significantly higher than that in the control group （76.1%）, the difference was statistically significant （P〈0.05 ）. Conclusion methylprednisolone combined with cyclophosphamide therapy can significantly improve systemic lupus patients serum cell factor,immunoglobulin and complement levels,and the effect is significant,thus is worth a wide application.