糖皮质激素联合小剂量三尖杉酯碱治疗系统性红斑狼疮的临床观察  

Treatment of systemic lupus erythematosus with prednisone in combination with small dose of harringtonine

作　　者：钟建庭[1] 方玲[1] 王璇[1] 叶夏云[1] 许瑞元[1] 姜一真[1] 王春雨[1] 赵玲[1] 杜军[1] 陆伟[1] 

机构地区：[1]兰州军区兰州总医院内分泌科,甘肃兰州730050

出　　处：《军医进修学院学报》2010年第5期414-415,共2页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的观察糖皮质激素联合三尖杉酯碱治疗系统性红斑狼疮（SLE）的疗效。方法36例SLE患者给予强的松0.8~1mg（kg/d）,4~8周后开始按每周5mg减量,维持量10~20mg/d;三尖杉酯碱1mg＋0.9%氯化钠注射液500ml静脉滴注,5~7d为1个疗程,间隔2~3周,共3~6个疗程。定期检测血常规、24h尿蛋白定量、血肌酐、白蛋白、免疫球蛋白、C3、C4、抗ANA抗体、抗ds-DNA抗体及抗SM抗体水平,比较治疗前后各项指标的变化。结果狼疮活动积分表（SLEDAI）评分由治疗前平均14.36分降至5.16分,24h尿蛋白定量、ESR水平较治疗前明显下降（P〈0.05）,抗ANA抗体转阴率87.5%,抗ds-DNA抗体、抗SM抗体转阴率分别为87.5%和83.3%。结论糖皮质激素联合三尖杉酯碱治疗SLE具有疗效高,不良反应小,价格低的特点,值得临床应用。Objective To observe the therapeutic effect of prednisone in combination with small dose of harringtonine（Har） on systemic lupus erythematosus（SLE）.Methods 36 SLE patients were treated with prednisone（0.8-1mg/kg·d） for 6-8 weeks,followed by 5mg a week.The maintenance dose of prednisone was 10-20mg/d.Then,the patients were treated with intravenous drip of Har in 500ml saline at 2-3 weeks interval,5-7 days a course for 3-6 courses.Blood routine examination,24h urine protein,blood creatinine,albumin,immunoglobulin,C3,C4,and anti-ANA,anti-ds-DNA and anti-SM antibodies were regularly detected and compared before and after treatment.Results The SLEDAI score was decreased to 5.16 from 14.36.The 24h urine protein and ESR levels were significantly lower after treatment than before treatment（P0.05）.The seroconversion rate of anti-dsDNA,anti-SM and anti-ANA was 87.5%,88.8% and 83.3%,respectively after treatment.Conclusion Prednisone in combination with Har is rather effective for SLE with few side effects and low cost and can thus be used in clinical practice.

关 键 词：红斑狼疮 系统性 三尖杉酯碱 糖皮质激素类 

分 类 号：R593[医药卫生—内科学]