發(fā)布時(shí)間：2019-03-01 11:11

【摘要】：目的對(duì)比他克莫司與環(huán)磷酰胺配合免疫吸附法治療老年系統(tǒng)性紅斑狼瘡腎炎(SLEN)的療效及其對(duì)炎性和免疫功能指標(biāo)的影響。方法老年SLEN患者86例,隨機(jī)分為他克莫司+免疫吸附治療組(他克莫司組)和環(huán)磷酰胺+免疫吸附治療組(環(huán)磷酰胺組),每組各43例。分別觀察兩組患者的治療效果并檢測(cè)炎癥反應(yīng)因子和免疫功能指標(biāo)的改變。結(jié)果治療后他克莫司組完全緩解(CR)和部分緩解(PR)患者分別為32例和8例,總體有效率為93.02%,顯著高于環(huán)磷酰胺組(74.42%,χ~2=5.460,P=0.019);且他克莫司組的不良反應(yīng)發(fā)生率為11.62%%,也顯著低于環(huán)磷酰胺組(30.23%,χ~2=4.497,P=0.034)。此外,盡管治療后兩組患者的腎功能指標(biāo)尿蛋白、尿素氮、肌酐和白蛋白、抗核抗體、白細(xì)胞介素(IL)-6、IL-8、IL-12、IL-16和腫瘤壞死因子(TNF)-α及免疫功能指標(biāo)IgA、IgM、IgG、補(bǔ)體C3和C4及T細(xì)胞亞群CD3~+、CD4~+、CD8~+和CD4~+/CD8~+均得以改善(P0.05),但是他克莫司組患者的上述各項(xiàng)指標(biāo)的改善程度亦明顯優(yōu)于環(huán)磷酰胺組(P0.05)。結(jié)論他克莫司聯(lián)合免疫吸附法對(duì)老年狼瘡腎炎具有良好的臨床療效,且能夠明顯改善機(jī)體的炎癥反應(yīng)和免疫功能。
[Abstract]:Aim to compare the efficacy of tacrolimus and cyclophosphamide combined with immunoadsorption in the treatment of elderly patients with systemic lupus erythematosus nephritis (SLEN) and its effect on inflammatory and immune function. Methods 86 elderly patients with SLEN were randomly divided into tacrolimus immunoadsorption group (tacrolimus group) and cyclophosphamide immunoadsorption treatment group (cyclophosphamide group) with 43 cases in each group. The therapeutic effects of the two groups were observed, and the changes of inflammatory reaction factor and immune function index were detected. Results after treatment, there were 32 patients with complete remission of (CR) and 8 patients with partial remission (PR) in tacrolimus group. The overall effective rate was 93.02%, which was significantly higher than that in cyclophosphamide group (74.42%, 蠂 ~ 2 / 5.460, P = 0.019). The incidence of adverse reactions in tacrolimus group was 11.62%, which was significantly lower than that in cyclophosphamide group (30.23%, 蠂 ~ 2 / 4.497, P = 0.034). In addition, although after treatment, urinary protein, urea nitrogen, creatinine and albumin, antinuclear antibodies, interleukin-6 (IL)-6), interleukin-8 (IL-8), and interleukin-12 (IL-12) were measured in both groups. IL-16, tumor necrosis factor (TNF)-偽, IgA,IgM,IgG, complement C3 and C4 and T cell subsets CD3~, CD4~, CD8~ and CD4~ / CD8~ were improved (P0.05). However, the improvement of the above indexes in the tacrolimus group was significantly better than that in the cyclophosphamide group (P0.05). Conclusion Tacrolimus combined with immunoadsorption has a good clinical effect on lupus nephritis in the elderly, and can significantly improve the inflammatory response and immune function of the body.
【作者單位】： 右江民族醫(yī)學(xué)院附屬醫(yī)院腎內(nèi)科;
【分類號(hào)】：R593.242
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本文編號(hào)：2432377