泼尼松联合甲氨喋啶治疗对系统性红斑狼疮患者炎症因子及免疫球蛋白表达水平的影响

Effects of Prednisone Combined with Methotrexate on Expression of Cytokines and Immunoglobulin IL-17 and IL-23 in Peripheral Blood of Patients with Systemic Lupus Erythematosus

【目的】探讨泼尼松联合甲氨喋啶治疗系统性红斑狼疮(SLE)患者对外周血清中的炎症因子白细胞介素-17(IL-17)和白细胞介素-23(IL-23)及免疫球蛋白表达水平的影响。【方法】在本院治疗的74例SLE患者,随机分为两组,各37例。对照组采用醋酸泼尼松治疗,观察组在对照组基础上联合甲氨喋啶治疗,3个月治疗后对患者治疗效果进行评估,比较两组治疗前后免疫球蛋白(IgA、IgG及IgM)、IL-17、IL-23水平及药物安全性。【结果】观察组治疗后3个月免疫球蛋白IgM、IgG、IgA水平均高于对照组(P<0.05);IL-17、IL-23水平均低于对照组(P<0.05);观察组与对照组治疗过程中胃肠道反应、肝肾功能损害等不良反应发生率相比较差异均无显著性(P>0.05)。【结论】将泼尼松联合甲氨喋啶用于系统性红斑狼疮患者中有助于改善患者免疫球蛋白水平,降低IL-17、IL-23水平,且未增加药物不良反应。

【Objective】To investigate the clinical effect of prednisone combined with methotrexate on the expression ol interleukin-17(IL-17),interleukin-23(IL-23)and immunoglobulin in peripheral plasma in patients with systemic lupus erythematosus(SLE).【Methods】A total of 74 patients with systemic lupus erythe-matosus treated in our hospital were randomly divided into two groups(n=37).The control group was treated with prednisone acetate,while the observation group was treated with methotrexate on the basis of the control group.After,three months of treatment,the clinical effects were evaluated.The Immunoglobulm(IgA,IgG and IgM),IL-17,IL-23 and drug safety were compared between the two groups.【Results】Tlie levels of IgM,IgG and IgA in the observation group were higher than those in the control group at 3 months after treatment(P<0.05),while the levels of IL-17 and IL-23 in the observation group were lower than those in the control group at 3 months after treatment(P<0.05).There were no significant differences in gastrointestinal reactions,liver and kidney function damage between the observation group and the control group during treatment(P>0.05).【Conclusion】Prednisone combined with methotrexate can improve the level of immunoglobulin in patients with systemic lupus erythematosus,reduce the levels of IL-17 and IL-23,and do not increase adverse drug reactions.