甲泼尼龙联合吗替麦考酚酯和丙种球蛋白治疗难治性狼疮肾炎的疗效研究  

Efficacy of Methylprednisolone Combined with Mycophenolate Mofetil and Gamma Globulin in the Treatment of Refractory Lupus Nephritis

作　　者：杨祯任 吴千丽 杨竹林 YANG Zhenren;WU Qianli;YANG Zhulin(Huiyang Sanhe hospital,Huizhou,Guangdong 516211)

机构地区：[1]惠阳三和医院,广东惠州516211

出　　处：《智慧健康》2022年第4期109-112,共4页Smart Healthcare

基　　金：惠州市科技计划项目,课题名称:甲泼尼龙联合吗替麦考酚酯和丙种球蛋白治疗难治性狼疮肾炎的疗效研究,课题编号:2020Y299

摘　　要：目的探讨甲泼尼龙联合吗替麦考酚酯和丙种球蛋白治疗难治性狼疮肾炎(LN)的疗效。方法将我院2020年3月-2021年7月收治的92例难治性LN患者分组,按照随机数字表法分为对照组46例,给予甲泼尼龙联合吗替麦考酚酯治疗,观察组46例在对照组基础上给予丙种球蛋白治疗,观察两组免疫水平、炎症水平、症状改善时间及不良反应。结果治疗后,观察组C3、ALB水平均高于对照组,ANA、尿蛋白定量水平均低于对照组(P<0.05);观察组白介素-4、白介素-10、白介素-18、γ-干扰素水平均低于对照组(P<0.05);观察组皮损减轻、体温下降及疼痛缓解时间均短于对照组(P<0.05);观察组不良反应发生率(6.52%)与对照组(10.86%)对比差异无统计学意义(P>0.05)。结论甲泼尼龙联合吗替麦考酚酯和丙种球蛋白治疗难治性狼疮肾炎可显著提高免疫力,降低炎症水平,缩短症状改善时间,且不增加药物不良反应。Objective To investigate the efficacy of methylprednisolone combined with mycophenolate mofetil and gamma globulin in the treatment of refractory lupus nephritis(LN).Methods 92 patients with refractory LN in our hospital from March 2020 to July 2021 were divided into two groups according to the random number table method.46 patients in the control group were treated with methylprednisolone combined with mycophenolate mofetil.46 patients in the observation group were treated with gamma globulin on the basis of the control group.The immune level,inflammatory level,symptom improvement time and adverse reactions of the two groups were observed.Results After treatment,the levels of C3 and ALB in the observation group were higher than those in the control group,and the quantitative levels of ANA and urinary protein were lower than those in the control group(P<0.05);The levels of IL-4,IL-10,IL-18 andγinterferon in the observation group were lower than those in the control group(P<0.05);The time of skin lesion relief,hypothermia and pain relief in the observation group were shorter than those in the control group(P<0.05);There was no significant difference in the incidence of adverse reactions between the observation group(6.52%)and the control group(10.86%)(P>0.05).Conclusion Methylprednisolone combined with mycophenolate mofetil and gamma globulin in the treatment of refractory lupus nephritis can significantly improve immunity,reduce the level of inflammation,shorten the time of symptom improvement,and do not increase adverse drug reactions.

关 键 词：丙种球蛋白 狼疮肾炎 难治性 甲泼尼龙 吗替麦考酚酯 

分 类 号：R593.242[医药卫生—内科学]