环磷酰胺联合雷公藤制剂治疗狼疮性肾炎患者的疗效及对其血清CXCL166、RF、MMP-9以及TIMP-1的影响  

Effects of cyclophosphamide combined with Tripterygium wilfordii preparation on serum chemokine ligand 16,RF,MMP-9 and TIMP-1 in patients with lupus nephritis and rheumatism.

作　　者：王健[1] 石慧婧 李娜[1] WANG Jian;SHI Hui-jing;LI Na(Department of Rheumatology and Immunology,Kailuan General Hospital,Tangshan Hebei 063000,China.)

机构地区：[1]河北省唐山市开滦总医院风湿免疫科,河北唐山063000

出　　处：《临床和实验医学杂志》2021年第10期1073-1076,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省2020年度医学科学研究课题计划项目(编号:20201439)

摘　　要：目的探究环磷酰胺联合雷公藤制剂治疗狼疮性肾炎(LN)患者的疗效及对其血清趋化因子配体16(CXCL16)、类风湿因子(RF)、基质金属蛋白酶9(MMP-9)及基质金属蛋白酶抑制物1(TIMP-1)的影响。方法前瞻性选取2018年6月至2019年9月开滦总医院收治的LN患者86例,采用随机数字表法将其分为研究组和对照组,每组各43例。观察组患者采取环磷酰胺联合雷公藤制剂方案进行治疗,对照组患者采取环磷酰胺方案进行治疗,疗程8个月。观察2组患者治疗前、治疗8个月后血清CXCL16、RF、TIMP-1和MMP-9含量的变化,临床疗效以及不良反应发生情况。结果治疗前,2组患者血清CXCL16、RF、TIMP-1和MMP-9含量比较,差异均无统计学意义(P>0.05)。治疗8个月后,观察组患者血清CXCL16含量为(2.35±0.33)mg/L,与对照组(2.34±0.31)mg/L比较,差异无统计学意义(P>0.05)。治疗8个月后,观察组患者血清RF、MMP-9含量分别为(15.11±4.09)RU/mL、(13.37±2.66)μg/L,均低于对照组[(21.53±5.37)RU/mL、(16.03±2.78)μg/L],TIMP-9含量(22.17±2.81)μg/L,高于对照组[(17.54±2.88)μg/L],差异均有统计学意义(P<0.05)。观察组治疗有效率为90.70%,高于对照组的74.42%,差异有统计学意义(P<0.05)。观察组不良反应发生率为9.30%,与对照组的11.63%比较,差异无统计学意义(P>0.05)。结论与单纯环磷酰胺比较,采取环磷酰胺联合雷公藤制剂治疗LN患者疗效更加显著,能显著降低RF、MMP-9水平,同时提高TIMP-1水平,对血清CXCL16无不良影响,安全性较好,值得临床借鉴。Objective To explore the efficacy of cyclophosphamide combined with Tripterygium wilfordii in the treatment of patients with lupus nephritis(LN)and its serum chemokine ligand 16(CXCL16),rheumatoid factor(RF),matrix metalloproteinase 9(MMP-9)and matrix The impact of metalloproteinase inhibitor-1(TIMP-1).Methods From June 2018 to September 2019,86 patients with LN admitted to Kailuan General Hospital were prospectively selected and divided into a study group and a control group using a random number table method,with 43 cases in each group.The observation group was treated with cyclophosphamide combined with Tripterygium wilfordii preparations,and the control group was treated with cyclophosphamide regimens for 8 months.The levels of serum CXCL16,RF,TIMP-1 and MMP-9,clinical efficacy and adverse reactions of the two groups before treatment and 8 months after treatment were observed and compared.Results Before treatment,there was no significant difference in the levels of serum CXCL16,RF,TIMP-1 and MMP-9 between the two groups of patients(P>0.05).After 8 months of treatment,the levels of serum CXCL16 in the observation group was(2.35±0.33)mg/L,compared with the control group(2.34±0.31)mg/L,the difference was not statistically significant(P>0.05).After 8 months of treatment,the levels of serum RF and MMP-9 in the observation group were(15.11±4.09)RU/mL and(13.37±2.66)μg/L,respectively,which were lower than those in the control group[(21.53±5.37)RU/mL,(16.03±2.78)μg/L],the level of TIMP-9 was(22.17±2.81)μg/L,which was higher than that in the control group[(17.54±2.88)μg/L],the difference was statistically significant(P<0.05).The effective rate of treatment in the observation group was 90.70%,which was higher than 74.42%in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 9.30%,compared with 11.63%in the control group,the difference was not statistically significant(P>0.05).Conclusion Compared with cyclophosphamide alon

关 键 词：狼疮性肾炎 环磷酰胺 雷公藤制剂 趋化因子配体16 类风湿因子 基质金属蛋白酶抑制物-1 

分 类 号：R593.242[医药卫生—内科学]