卢帕他定治疗慢性自发性荨麻疹的疗效观察

Observation on efficacy of rupatadine in treating chronic spontaneous urticaria

目的探讨卢帕他定对慢性自发性荨麻疹(CSU)患者的疗效及其对外周血中T细胞亚群的影响。方法将80例CSU患者分为2组,治疗组给予富马酸卢帕他定片口服治疗,对照组予以氯雷他定口服治疗,治疗疗程为12周。分别对2组患者治疗前及治疗后第4、8、12周的病情进行评估,记录不良反应及复发情况。同时,选择同期35名健康体检者为健康组,抽取所有研究对象治疗前及治疗12周后的外周静脉血,检测T淋巴细胞亚群水平。比较治疗后治疗组和对照组临床荨麻疹活动度症状评分(UAS7)。结果治疗12周后,治疗组总有效率为90.63%,高于对照组的65.63%,治疗组复发率为12.12%,低于对照组的37.50%,差异均有统计学意义(P <0.05)。治疗后4、8、12周,治疗组和对照组UAS7评分均显著下降,不同时点UAS7评分与治疗前比较,差异均有统计学意义(P <0.05)。治疗第8周、12周,治疗组UAS7评分低于对照组,差异有统计学意义(P <0.05)。治疗组和对照组治疗前CD3+、CD8+水平低于健康组,CD4+/CD8+高于健康组,差异有统计学意义(P <0.05)。治疗后,治疗组和对照组CD3+、CD8+较治疗前显著升高,CD4+/CD8+比值显著下降(P <0.05),且治疗组变化更为显著,差异有统计学意义(P <0.05)。治疗后,治疗组CD3+、CD4+、CD8+、CD4+/CD8+水平与健康组比较,差异无统计学意义(P> 0.05);对照组CD3+及CD8+水平均低于健康组及治疗组,CD4+/CD8+比值均高于健康组及治疗组,差异有统计学意义(P <0.05)。结论卢帕他定治疗CSU的疗效显著,能够降低复发率且不良反应少,能够有效纠正CSU患者的T淋巴细胞亚群紊乱状态。

Objective To explore the influence of rupatadine in treating patients with chronic idiopathic urticaria( CSU) and its effects on T cell subsets in peripheral blood. Methods A total of 80 patients with CSU were divided into two groups. The treatment group was given oral administration of rupatadine fumarate tablets,while the control group was given loratadine for oral administration,the course of treatment was 12 weeks. The disease conditions of patients in the two groups were evaluated before treatment and at 4,8 and 12 weeks after treatment,and their adverse reactions and recurrence conditions were recorded. Besides,35 healthy people with physical examinations were selected as healthy group. The peripheral venous blood before treatment and after 12 weeks of treatment was collected from all the included subjects,and levels of T lymphocyte subsets were detected. Clinical urticaria activity symptom score( UAS7) was compared between treatment group and control group after treatment. Results After 12 weeks of treatment,the total effective rate of the treatment group was 90. 63%,which was significantly higher than 65. 63% of the control group,and the recurrence rate of the treatment group was 12. 12%,which was significantly lower than 37. 50% of the control group,and the differences were statistically significant( P < 0. 05). After 4,8 and 12 weeks of treatment,UAS7 scores in treatment group and the control group decreased significantly,and showed significant differences when compared with treatment before( P < 0. 05). At week 8 and 12 of the treatment,UAS7 scores of the treatment group were lower than that of the control group,and the differences were statistically significant( P < 0. 05). Before treatment,the levels of CD3^+and CD8^+in the treatment group and the control group were significantly lower than those in the healthy group,and CD4^+/CD8^+ ratio was significantly higher than that in the healthy group( P < 0. 05).After treatment,CD3^+ and CD8^+ in the treatment group and the control group were significantly increased,and CD4^+/CD8^+ ratio was significantly decreased compared with before treatment( P <0. 05),and the change in the treatment group was more significant( P < 0. 05). After treatment,the levels of CD3^+,CD4^+,CD8^+ and CD4^+/CD8^+ ratio in the treatment group were showed no significant difference compared with those in the healthy group( P > 0. 05). The levels of CD3^+ and CD8^+ in the control group were significantly lower than those in the healthy group and the treatment group,and the CD4^+/CD8^+ ratio was significantly higher than that in the healthy group and the treatment group( P < 0. 05). Conclusion Rupatadine is effective in the treatment of chronic spontaneous urticaria,and it has lower recurrence rate and less adverse reactions. Besides,it can effectively correct the disorder of T lymphocyte subsets in patients with chronic spontaneous urticaria.