贝利尤单抗治疗狼疮性肾炎的疗效及其相关因素分析:一项真实世界队列研究

A cohort study of lupus nephritis patients in remission and its associated factors:a real-world study of 58 hospital patient

目的探讨狼疮性肾炎(LN)患者12个月肾脏缓解情况,并分析影响其缓解的相关因素。方法通过回顾性队列研究分析LN患者使用生物制剂的缓解情况,研究纳入57例尿蛋白为阳性的LN患者,分为激素+免疫制剂组39例及激素+免疫制剂+生物制剂组18例。激素+免疫制剂组患者使用标准治疗方案,激素+免疫制剂+生物制剂组患者在标准治疗方案基础上加用注射用贝利尤单抗。长期随访,收集和分析肾脏反应和临床特征的数据。结果纳入患者57例,有41例(71.93%)达到肾脏完全缓解,16例(28.07%)达到部分缓解。激素+免疫抑制剂组39例患者中有29例患者达到完全缓解(平均完全缓解时间7.846个月,95%CI:6.626~9.066),激素+免疫抑制剂+生物制剂组18例患者中有12例患者达到完全缓解(平均完全缓解时间4.167个月,95%CI:3.461~4.872)。结论同时使用激素+免疫制剂+生物制剂的患者较仅使用激素+免疫制剂的患者能更快的达到完全缓解。

Objective To investigate the 12-month renal remission in patients with lupus nephritis(LN)and the predictive factors.Methods The remission of patients with LN using biologic agents was analyzed by a prospective cohort study that included 57 patients with LN and positive urine protein,who were divided into hormone+immunosuppression group(n=39)and hormone+immunosuppression+biologics group(n=18).Patients in hormone+immunosuppression group received standard therapy and those in hormone+immunosuppression+biologics group received standard therapy and belimumab.Long-term follow-up was assigned to collect and analyze data on renal response and clinical characteristics.Results Renal complete remission was achieved in 41 out of 57 patients(71.93%)and partial remission was achieved in 16 patients(28.07%).Complete remission was achieved in 29 out of 39 patients in the hormone+immunosuppression group(mean time to complete remission was 7.846 months,95%CI:6.626-9.066 months)and in 12 out of 18 patients in the hormone+immunosuppression+biologics group(mean time to complete remission was 4.167 months,95%CI:3.461-4.872 months).Conclusion Patients using both hormones,immune agents and biologics achieve complete remission more quickly than those using only hormones and immune agents.