二甲双胍治疗系统性红斑狼疮的临床疗效及其对Ⅰ型干扰素诱导基因表达的影响

A Clinical Study of Metformin in the Treatment of Systemic Lupus Erythematosus and Its Effect on Type I Interferon-Induced Gene Expression

目的探究二甲双胍治疗系统性红斑狼疮(systemic lupus erythematosus,SLE)的临床疗效及其对Ⅰ型干扰素(IFN)诱导基因表达的影响。方法研究对象选取我院2020年1月至2021年2月期间收治入院的SLE患者96例,采用随机数字法将其分为对照组和观察组,每组48例。对照组患者给予激素、免疫抑制剂等常规治疗,在此基础上,观察组患者联合二甲双胍治疗12周。比较两组患者的治疗总有效率、同时比较两组患者治疗前后的SLE疾病活动指数(SLEDAI)、24 h尿蛋白定量(UAE)、血肌酐(Scr)、免疫学相关指标水平、Ⅰ型IFN诱导基因表达水平及不良反应发生率。结果观察组的治疗总有效率(95.83%)明显高于对照组(79.17%)(χ^(2)=4.67,P=0.03)。治疗后,观察组患者的SLEDAI评分、血清Scr、UAE、IgA、IgG和IgM水平均明显低于对照组(P<0.05);观察组患者的血清C3、C4水平均明显高于对照组(P<0.05)。同时,治疗后,观察组患者Ⅰ型IFN诱导基因MX1、OAS1、ISG15、LY6E的mRNA表达水平均明显低于对照组(P<0.05)。观察组与对照组不良反应发生率差异无统计学意义(P>0.05)。结论二甲双胍治疗SLE的临床疗效显著,能有效控制疾病的活动度,同时能降低Ⅰ型IFN诱导基因的表达水平,值得在临床推广。

Objective To explore the clinical efficacy of metformin in the treatment of systemic lupus erythematosus(SLE)and its effect on type I interferon(IFN)-induced gene expression.Methods The study subjects included 96 SLE patients admitted to our hospital from January,2020 to January,2021,and we divided these patients into a control group and an observation group using a random number method,with 48 cases in each group.Patients in the control group were given conventional treatments such as hormones and immunosuppressants.In addition,patients in the observation group were treated with metformin for 12 weeks.We compared the total effective rate of treatment of the two groups of patients,and also compared the SLE disease activity index(SLEDAI),serum creatinine(Scr),24h urine protein(UAE),immunological related index levels,and type I IFN induction before and after treatment,as well as gene expression level and incidence of adverse reactions.Results The total effective rate of treatment in the observation group(95.83%)was significantly higher than that in the control group(79.17%)(χ^(2)=4.67,P=0.03).After treatment,the SLEDAI score,serum Scr,UAE,IgA,IgG and IgM levels of the observation group were significantly lower than those of the control group(P<0.05).Serum C3 and C4 levels of the observation group were significantly higher than those of the control group(P<0.05).After treatment,mRNA expression levels of type I IFN-induced genes MX1,OAS1,ISG15 and LY6E in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Metformin has a significant clinical effect on the treatment of SLE,which can effectively control the activity of the disease and reduce the expression level of type I IFN-induced genes.It is worthy of a clinical promotion.