他克莫司联合环磷酰胺治疗系统性红斑狼疮疗效及对血清单核细胞趋化蛋白4、可溶性白细胞介素-2受体影响

Curative efficacy of tacrolimus combined with cyclophosphamide in treatment of systemic lupus erythematosus and its effectson serum MCP4 and sIL-2R

目的探讨他克莫司联合环磷酰胺治疗系统性红斑狼疮(SLE)的疗效及对血清单核细胞趋化蛋白4(MCP4)、可溶性白细胞介素-2受体(sIL-2R)的影响。方法选取自2017年8月至2018年9月兰州大学第二医院及西北妇女儿童医院收治的100例SLE患者为研究对象。采用随机数字表法将其分为A组(n=45)与B组(n=55)。A组采用环磷酰胺治疗,B组采用他克莫司联合环磷酰胺治疗。比较两组患者的临床疗效,血清MCP4、sIL-2R水平,24 h尿蛋白,系统性红斑狼疮疾病活动指数(SLEDAI)评分及不良反应发生情况。结果治疗后,B组患者总有效率为92.7%(51/55),显著高于A组的71.1%(32/45),两组间比较,差异有统计学意义(P<0.05);治疗后,B组患者的血清MCP4、sIL-2R水平及SLEDAI评分、24 h尿蛋白改善程度均显著优于A组,两组间比较,差异均有统计学意义(P<0.05);B组患者不良反应发生率为16.4%(9/55),低于A组的51.1%(23/45),差异有统计学意义(P<0.05)。结论他克莫司联合环磷酰胺治疗SLE疗效显著,可有效改善血清MCP4、sIL-2R水平,且安全性较高。

Objective To investigate the curative efficacy of tacrolimus combined with cyclophosphamide in treatment of systemic lupus erythematosus(SLE)and its effects on serum monocyte chemotactic protein 4(MCP4),soluble interleukin-2 receptor(sIL-2 R)were analyzed.Methods A retrospective study was performed on 100 cases of SLE patients who were admitted from August 2017 to September 2018.Patients were randomly divided into the Group A(n=45)and Group B(n=55).Patients of Group A were treated with cyclophosphamide,the others of Group B were treated with cyclophosphamide.The clinical efficacy,serum MCP4,sIL-2 R,24-hour urinary protein,SLEDAI score and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of patients in Group B was 92.7%(51/55),significantly higher than that of Group A,71.1%(32/45).The difference between the two groups was statistically significant(P<0.05).After treatment,the serum MCP4,sIL-2 R level,SLEDAI score and 24-hour urinary protein improvement degree of Group B were significantly better than those of Group A(P<0.05).The incidence of adverse reactions between the two groups was statistically significant(P<0.05).Conclusion Application of tacrolimus combined with cyclophosphamide in SLE patients has significant efficacy,and can effectively improve the serum MCP4 and sil-2 r levels,with high safety.