他克莫司联合利妥昔单抗治疗系统性红斑狼疮的临床疗效

Clinical Efficacy of Tacrolimus Combined with Rituximab in the Treatment of Systemic Lupus Erythematosus

目的他克莫司联合利妥昔单抗治疗系统性红斑狼疮的临床疗效。方法方便选取自2016年1月-2017年6月份该院收治的系统性红斑狼疮患者56例,分为治疗组和对照组。采用不同治疗方案,比较两组患者治疗效果。结果治疗后治疗组患者IgA(2.03±0.21)g/L,对照组IgA(2.43±0.34)g/L(t=5.296 5,P<0.05);治疗组IgM(1.30±0.31)g/L,对照组IgM(1.57±0.45)g/L(t=2.614 6,P=0.011 6);治疗组IgG(13.5±1.57)g/L,对照组IgG(15.8±2.34)g/L(t=4.318 9,P=0.000 1),治疗组C3(0.63±0.14)g/L,对照组C3(0.49±0.23)g/L(t=2.751 3,P=0.008 1);治疗组C4(0.21±0.04)g/L;对照组C4(0.13±0.05)g/L(t=6.611 2,P<0.05)。以上数值两两对比,差异有统计学意义(P<0.05)。治疗后治疗组ASm转阴率47.83%,对照组转阴率19.05%(χ2=4.046 2,P=0.044 3)。治疗后治疗组ANA转阴率65.38%,对照组转阴率36.00%(χ2=4.403 6,P=0.035 8)。治疗后治疗组转阴率66.67%,对照组转阴率38.46%(χ2=4.228 4,P=0.039 7)。两两分析差异有统计学意义(P<0.05)。治疗组不良反应发生率为10.71%;对照组不良反应发生率为35.71%,差异有统计学意义(χ~2=4.908 8,P=0.026 7 <0.05)。在治疗后的一年跟踪观察中,治疗组复发率0.07%;对照组复发率为28.57%,差异有统计学意义(χ2=4.382 6,P=0.036 3 <0.05)。结论他克莫司联合利妥昔单抗治疗系统性红斑狼疮临床效果显著,不良反应低,复发率低,值得临床推广使用。

Objective To compare the clinical efficacy of tacrolimus combined with rituximab in the treatment of systemic lupus erythematosus. Methods A total of conveniently selected 56 patients with systemic lupus erythematosus admitted to this department from January 2016 to June 2017 were divided into treatment group and control group. The treatment effect was compared between the two groups using different treatment options. Results After treatment, patients in the treatment group had IgA (2.03±0.21) g/L, control group IgA (2.43±0.34) g/L(t=5.296 5, P<0.05);treatment group IgM (1.30±0.31) g/L, control group IgM (1.57±0.45) g/L(t=2.614 6, P=0.011 6);IgG (13.5±1.57) g/L in the treatment group, IgG (15.8±2.34) g/L in the control group,(t=4.318 9, P=0.000 1), treatment group C3 (0.63±0.14)g/L, control group C3 (0.49±0.23)g/L(t=2.751 3, P=0.008 1);treatment group C4(0.21±0.04)g/L;control group C4 (0.13±0.05) g/L(t=6.611 2, P<0.05). The above values were compared in pairs(P<0.05), and the difference was statistically significant. After treatment, the conversion rate of ASm in the treatment group was 47.83%, and that in the control group was 19.05%(χ2=4.046 2, P=0.044 3). After treatment, the ANA conversion rate was 65.38% in the treatment group and 36.00% in the control group(χ2=4.403 6, P=0.035 8). After treatment, the conversion rate of the treatment group was 66.67%, and the conversion rate of the control group was 38.46%(χ2=4.228 4, P=0.039 7), pairwise analysis(P<0.05), the difference was statistically significant. The incidence of adverse reactions in the treatment group was 10.71%;the incidence of adverse reactions in the control group was 35.71%, and the difference was statistically significant(χ2=4.908 8, P=0.026 7 <0.05). In the follow-up observation one year after treatment,the recurrence rate of the treatment group was 0.07%;the recurrence rate of the control group was 28.57%(χ2=4.382 6, P=0.036 3, P<0.05), and the difference was statistically significant. Conclusion The clinical effect of tacrolimus combined with rituximab in the treatment of systemic lupus erythematosus is significant, with low adverse reactions and low recurrence rate, which is worthy of clinical promotion.