羟氯喹治疗干燥综合征患者的疗效

Efficacy of hydroxychloroquine in patients with Sjogren's syndrome

目的探讨真实世界中羟氯喹用于干燥综合征患者的疗效。方法纳入2016年5月至2018年12月在国家风湿病数据中心(CRDC)数据库中登记的资料完整的原发性干燥综合征患者,收集其中在观察期单纯应用羟氯喹,且有9~15个月随访资料患者治疗前后的临床资料、实验室指标、ESSDAI评分、ESSPRI评分、医师总体疾病评分,进行统计分析。结果满足入组条件的干燥综合征患者共54例,其中女性53例,年龄(45.5±12.9)岁。病程(确诊到入组时间)13(3,32)个月。治疗后脏器受累无显著改变,治疗后较治疗前血沉[(21.9±15.0)mm/h vs.(19.4±16.8)mm/h]及免疫球蛋白IgA[(3.0±1.2)g/L vs.(2.6±1.1)g/L、IgG(17.4±5.6)g/L vs.(16.2±5.8)g/L、IgM(1.4±0.6)g/L vs.(1.2±0.5)g/L、ESSDAI评分(3.4±5.8)vs.(1.8±3.9)、干燥主观评价(43.3±23.3)vs.(31.7±22.4)、疲乏主观评价(36.7±22.8)vs.(21.0±21.8)]、医师总体疾病评分(0.8±0.6)vs.(0.6±0.5)均显著下降(P<0.05)。结论单用羟氯喹治疗的干燥综合征患者多为无重要脏器受累,长期应用羟氯喹可能减轻乏力及干燥症状,降低疾病活动度。

Objective To investigate the efficacy of hydroxychloroquine(HCQ)in patients with Sjogren's syndrome(SS)in the real world.Methods The patients with SS from the Chinese Rheumatism Data Center(CRDC)database who were treated with HCQ alone and after 9-15 months of follow-up were enrolled,through May 2016 to December 2018.The clinical characteristics,laboratory examinations,ESSDAI score,ESSPRI score,Physician's Global Assessent(PGA)score were collected.Results Fifty-four patients met the entry criteria.Among them,53 patients were womne,and the average age was(45.5±12.9)years old.The median time of disease course(the time from diagnosis to entry)was 13(3,32)months.There were no significant differences in the incidences of organ involvements between baseline and follow-up.After HCQ therapy,erythrocyte sedimentation rate[(21.9±15.0)mm/h vs.(19.4±16.8)mm/h],immunoglobulin(Ig)A[(3.0±1.2)g/L vs.(2.6±1.1)g/L],IgG[(17.4±5.6)g/L vs.(16.2±5.8)g/L],IgM[(1.4±0.6)g/L vs.(1.2±0.5)g/L],ESSDAI score[(3.4±5.8)vs.(1.8±3.9)],VAS score(dryness)[(43.3±23.3)vs.(31.7±22.4)],VAS score(fatigue)[(36.7±22.8)vs.(21.0±21.8)],and PGA score[(0.8±0.6)vs.(0.6±0.5)]were significantly decreased(P<0.05).Conclusions The SS patients treated by HCQ alone are mostly without visceral organ involvements.Long-term application of HCQ may alleviate symptoms such as fatigue anddryness,and reduce disease activity in patients with SS.