羟氯喹联合环磷酰胺对系统性红斑狼疮患者Th1/Th2细胞因子平衡的影响

Effect of hydroxychloroquine combined with cyclophosphamide on Th1/Th2 cytokine balance in patients with systemic lupus erythematosus

目的 探讨羟氯喹联合环磷酰胺治疗系统性红斑狼疮(SLE)的治疗指标的变化,并分析其对患者Th1/Th2 细胞因子平衡的影响。方法 收集2016 年2 月至2018 年1 月本院收治的SLE 患者62例,按照随机数字表法分成对照组(31例,采用环磷酰胺治疗)和研究组(31例,采用羟氯喹+环磷酰胺治疗),对比两组治疗过程中不适症状的发生情况、治疗后治疗指标的变化,以及观察其对患者Th1/Th2 细胞因子平衡的影响。结果 治疗后,研究组Alb、血清补体C3 含量显著高于对照组,24 h 尿蛋白定量、SLEDAI、ESR、Scr、ALT 均低于对照组(均P<0.05);研究组IL-2、TGF-β细胞因子显著高于对照组,IFN-γ、IL-4、IL-10 细胞因子显著低于对照组(均P<0.05)。对照组不良反应发生率为29.03%(9/31),研究组为12.90%(4/31),差异无统计学意义(χ^2=2.433,P =0.119)。结论 羟氯喹联合环磷酰胺治疗SLE,治疗指标变化显著,可明显降低SLEDAI、24 h 尿蛋白定量和ESR、Scr、ALT,提高Alb、C3 水平,不良反应少,安全性较高。

Objective To investigate the effect of hydroxychloroquine combined with cyclophosphamide in the treatment of systemic lupus erythematosus (SLE), and to analyze its effect on the balance of Th1/Th2 cytokines in patients. Methods A total of 62 SLE patients admitted to our hospital from February, 2016 to January, 2018 were randomly divided into a control group (31 cases, treated with cyclophosphamide) and a study group (31 cases, treated with chloroquine and cyclophosphamide) according to the number table method. The incidence of discomfort during treatment, changes in treatment indicators after the treatment, and the effect on the balance of Th1/Th2 cytokines were compared between the two group. Results After the treatment, the serum contents of Alb and complement C3 were significantly higher and the 24 h urine protein quantitation, SLEDAI, ESR, Scr, and ALT were lower in the study group than in the control group (all P < 0.05);the IL-2 and TGF-β were significantly higher and the IFN-γ, IL-4, and IL-10 were significantly lower in the study group than in the control group (P < 0.05). The incidence of adverse reactions in the control group was 29.03%(9/31), and that in the study group 12.90%(4/31), with no statistical difference (χ^2=2.433, P=0.119). Conclusion Hydroxychloroquine combined with cyclophosphamide in the treatment of SLE can significantly change the treatment indicators, significantly decrease SLEDAI, 24 h urine protein quantitation, ESR, ESR, Scr, ALT, and improve Alb and C3 levels, and has fewer adverse reactions, and is safe.