糖皮质激素联合环磷酰胺治疗重症系统性红斑狼疮的效果

Effect of Glucocorticoid combined with Cyclophosphamide in the treatment of severe systemic lupus erythematosus

目的探讨糖皮质激素和环磷酰胺联合治疗重症系统性红斑狼疮的临床效果。方法选取2015年7月~2017年7月我院收治的98例重症系统性红斑狼疮患者作为研究对象,将其随机分为研究组和对照组,每组各49例,对照组采用糖皮质激素进行治疗,研究组采取糖皮质激素和环磷酰胺联合进行治疗。记录比较治疗前后两组患者的疾病活动指数(SLEDAI)评分、抗核抗体(ANA)、抗双联DNA抗体(ds-DNA)、补体C3、免疫球蛋白(Ig G)、尿蛋白、血肌酐(SCr)、血尿素氮(BUN)等指标的变化,并比较两组患者的不良反应情况。结果两组患者治疗后,各项指标均有明显改善(P<0.05);研究组患者治疗后的SLEDAI评分、ANA、ds-DNA以及Ig G水平的改善情况均优于对照组,各项肾功能指标的改善情况也优于对照组,差异有统计学意义(P<0.05);两组患者的不良反应情况比较,差异无统计学意义(P>0.05)。结论采用糖皮质激素和环磷酰胺联合治疗重症系统性红斑狼疮,能更有效地控制病情,改善患者的肾功能,提高临床治疗效果,且安全性较好,值得临床推广。

Objective To investigate the clinical effect of Glucocorticoid and Cyclophosphamide in the treatment of severe systemic lupus erythematosus.Methods From July 2015 to July 2017,98 patients with severe systemic lupus erythematosus were selected as the subjects,and randomly divided into study group and control group,with 49 cases in each group.The control group was treated with Glucocorticoid,while the study group was treated with Glucocorticoid and Cyclophosphamide.The changes of SLEDAI score,ANA,ds-DNA,complement C3,immunoglobulin(IgG),urinary protein,blood creatinine(SCr)and blood urea nitrogen(BUN)were recorded before and after treatment.And the adverse reactions were compared between the two groups.Results After treatment,the indexes of the two groups were significantly improved(P<0.05).The improvement of SLEDAI ANAds-DNA and IgG levels in the study group were significantly better than that in the control group,the improvement of the indexes of renal functions were also better than that of the control group(P<0.05).There was no significant difference in the adverse reaction between the two groups(P>0.05).Conclusion The combination of Glucocorticoid and Cyclophosphamide in the treatment of severe systemic lupus erythematosus can control the disease more effectively,improve the renal function of the patient,improve the clinical treatment effect,which has good safety and is worthy of clinical popularization.