艾拉莫德联合甲泼尼龙、硫酸羟氯喹对原发性干燥综合征合并间质性肺病的疗效  

Efficacy of iguratimod combined with methylprednisolone and hydroxychloroquine sulfate on primary Sjogren's syndrome with interstitial lung disease

作　　者：孟德钎[1] 李鞠[1] 李永胜[1] 刘姗姗[1] 刘娟[1] 王凯[1] 李慧[1] 张钟元 王国如[2] MENG De-qian;LI Ju;LI Yong-sheng;LIU Shan-shan;LIU Juan;WANG Kai;LI Hui;ZHANG Zhong-yuan;WANG Guo-ru(Department of Rheumatology,The Affiliated Huai an No.1 People's Hospital of Nanjing Medical University,Huai an,Jiangsu 223300,China;不详)

机构地区：[1]南京医科大学附属淮安第一医院免疫风湿科,江苏淮安223300 [2]南京医科大学附属淮安第一医院药剂科,江苏淮安223300

出　　处：《中国临床研究》2023年第1期85-89,共5页Chinese Journal of Clinical Research

基　　金：江苏省淮安市卫生健康面上项目(HAWJ201902)。

摘　　要：目的探讨艾拉莫德联合甲泼尼龙(美卓乐)、硫酸羟氯喹在原发性干燥综合征合并间质性肺病(ILD)患者治疗中的应用和临床疗效。方法选取南京医科大学附属淮安第一医院2020年1月至2021年12月符合原发性干燥综合征合并ILD、临床资料完备的门诊及住院患者60例,随机分为治疗组30例和对照组30例。对照组给予美卓乐联合硫酸羟氯喹口服治疗,治疗组在对照组基础上加用艾拉莫德片口服治疗。观察两组治疗前后呼吸困难修正评分量表(mMRC)评分、肺功能指标[用力肺活量(FVC)、单位肺泡容积的一氧化碳弥散量占预计值百分比(DLco/VA)]、免疫球蛋白(Ig)G和动脉氧分压(PaO_(2))水平,并进行对比。结果治疗12周后,治疗组mMRC评分[(1.82±0.63)分vs(2.26±0.79)分,P<0.05]低于对照组;治疗组FVC[(2.36±0.41)L vs(2.13±0.22)L]、DLco/VA[(70.83±5.99)%vs(65.17±6.22)%]均明显优于对照组(P<0.05);治疗组IgG水平[(15.86±4.38)g/L vs(19.03±4.67)g/L,P<0.05]低于对照组;治疗组PaO_(2)水平[(69.70±9.60)mm Hg vs(63.57±10.73)mm Hg,P<0.05]高于对照组。治疗组发生消化道症状2例,肝损害1例,对照组消化道症状2例,无其他严重并发症和不良反应发生。结论艾拉莫德联合美卓乐、硫酸羟氯喹对原发性干燥综合征合并ILD有一定短期临床疗效,能改善患者呼吸困难、肺功能、PaO_(2),降低IgG水平,优于美卓乐和硫酸羟氯喹两药联合治疗。Objective To investigate the clinical efficacy of iguratimod combined with methylprednisolone(medrol) and hydroxychloroquine sulfate in patients with primary Sjogren’s syndrome(pSS) complicated with interstitial pneumonia disease(ILD). Methods Sixty outpatients and inpatients with pSS and ILD treated in Huai’an No.1 People’s Hospital of Nanjing Medical University from January 2020 to December 2021 were randomly divided into treatment group and control group(n=30,each). Medrol tablets combined with hydroxychloroquine sulfate were given orally in control group, and iguratimod tablets were added in treatment group. The modified British Medical Research Council dyspnea scale(mMRC), pulmonary function indexes [forced vital capacity(FVC), DLco/VA(the percentage of diffusing capacity for carbon monoxide/alveolar volume to the predicted value) ] and the levels of immunoglobulin G(IgG) and arterial partial pressure of oxygen(PaO_(2)) were observed before and after treatment and compared between two groups. Results After 12 weeks of treatment, mMRC score in treatment group was statistically lower than that in control group [(1.82±0.63) vs(2.26±0.79), P<0.05];FVC[(2.36±0.41)L vs(2.13±0.22)L, P<0.05] and DLco/VA[(70.83±5.99)% vs(65.17±6.22)%, P<0.05] in treatment group were significantly superior to those in control group;IgG level [(15.86±4.38) g/L vs(19.03±4.67)g/L] significantly decreased in treatment group, and PaO_(2)[(69.70±9.60) mm Hg vs(63.57±10.73) mm Hg] increased compared with those in control group(P<0.05). There were 2 cases of digestive tract symptoms and 1 case of liver damage in treatment group and 2 cases of digestive tract symptoms in control group, without other serious complications and adverse reactions in two groups. Conclusion Iguratimod combined with methylprednisolone and hydroxychloroquine sulfate have the advantages of a better short-term effect on pSS with IPD. It can improve patient’s dyspnea, pulmonary function and PaO_(2), and reduce IgG level which is superior to the combinat

关 键 词：艾拉莫德 原发性干燥综合征 肺疾病 间质性 甲泼尼龙 硫酸羟氯喹 

分 类 号：R593.2[医药卫生—内科学]