糖皮质激素在系统性红斑狼疮中的应用及研究现状

Updates on Application and Clinical Research of Glucocorticoids in the Treatment of Systemic Lupus Erythematosus

糖皮质激素(GCs)是治疗系统性红斑狼疮(SLE)最主要的药物之一。然而,由于糖皮质激素的治疗效果因人而异,且长期应用可导致多种副作用,临床医生难以针对不同病情的SLE患者给予相对精准的糖皮质激素治疗方案。本文总结糖皮质激素在SLE不同进展阶段、不同脏器受累以及儿童、孕妇等特殊人群中最新的应用共识和研究进展,并分析SLE中糖皮质激素抵抗(GCR)的相关机制,针对糖皮质激素的副作用采取相应的防治策略,为糖皮质激素在SLE患者中的合理应用提供依据。

As the most commonly used medication, glucocorticoids（GCs） is a critical treatment for systemic lupus erythematosus（SLE）. However, owning to varying therapeutic responses of SLE patients to GCs and diverse adverse effects along with long-term use, it is difficult for clinicians to give relatively accurate GCs treatment regime for different conditions. In the review, the latest consensus and research progress of GCs in SLE patients with different disease stages, different organs damages and special populations such as children and pregnant women have been summarized. Furthermore, the related mechanisms of GCs resistance were analyzed, corresponding preventive and therapeutic strategies for the adverse effects of GCs were also proposed, providing an advanced understanding for the rational application of GCs in SLE patients.