泰它西普联合标准方案治疗Ⅲ-Ⅴ型活动性狼疮肾炎临床观察  

Clinical Observation of Telitacicept Combined with Standard Regimen in the Treatment of TypeⅢ-ⅤActive Lupus Nephritis

作　　者：林千祺 许夏雨 邢诒喜 黄美琼 姚奇岑 陈艺玲 梁金 陈维飞 LIN Qianqi;XU Xiayu;XING Yixi;HUANG Meiqiong;YAO Qicen;CHEN Yiling;LIANG Jin;CHEN Weifei(The Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan,China 570311)

机构地区：[1]海南医学院第二附属医院,海南海口570311

出　　处：《中国药业》2023年第12期97-100,共4页China Pharmaceuticals

基　　金：海南省医药卫生科研项目[2101320244A2001]。

摘　　要：目的探讨泰它西普联合标准方案治疗中重型活动性狼疮肾炎(LN)的临床疗效,以及对患者免疫功能的影响。方法选取医院2021年3月至2022年8月收治的中重型(Ⅲ-Ⅴ型)活动性LN患者90例,按治疗方案的不同分为观察组(44例)和对照组(46例)。两组患者均行标准方案治疗(先予注射用甲泼尼龙琥珀酸钠冲击治疗,后口服甲泼尼龙片,并口服来氟米特片、吗替麦考酚酯分散片诱导治疗),观察组患者加用注射用泰它西普腹部皮下注射治疗。两组均持续治疗24周。结果观察组总有效率为97.73%,显著高于对照组的82.61%(P<0.05)。两组患者治疗后的系统性红斑狼疮疾病活动度(SLE-DAI)评分均显著降低,且观察组降低更显著(P<0.05);CD_(19)+B细胞水平,免疫球蛋白(Ig)G,IgM,IgA,肿瘤坏死因子-α(TNF-α)水平均显著降低,补体C3和C4、白细胞介素2水平均显著升高,且观察组改善程度显著优于对照组(P<0.05);24 h尿蛋白、尿β_(2)-微球蛋白水平及尿红细胞数均显著降低,且观察组降低更显著(P<0.05)。观察组与对照组不良反应发生率相当(29.55%比19.57%,P>0.05)。结论泰它西普联合标准方案治疗Ⅲ-Ⅴ型活动性LN,可有效控制患者的SLE-DAI评分及相关肾脏损害指标,调节免疫功能,并缓解肾脏炎症。Objective To investigate the clinical efficacy of telitacicept combined with standard regimen in the treatment of moderate to severe active lupus nephritis(LN),and its effect on the immune function of patients.Methods A total of 90 patients with moderate to severe(typeⅢ-Ⅴ)active LN admitted to the hospital from March 2021 to August 2022 were selected and divided into the observation group(44 cases)and the control group(46 cases)according to different treatment regimens.The patients in the two groups were treated with the standard regimen(after completing pulse therapy with Methylprednisolone Sodium Succinate for Injection,taking Methylprednisolone Tablets orally and receiving induction therapy with Leflunomide Tablets and Mycophenolate Mofetil Dispersible Tablets),on this basis,the patients in the observation group were treated with abdominal subcutaneous injection of Telitacicept for Injection.Both groups were continuously treated for 24 weeks.Results The total effective rate in the observation group was 97.73%,which was significantly higher than 82.61%in the control group(P<0.05).After treatment,the systemic lupus erythematosus disease activity index(SLE-DAI)score in the two groups was significantly lower,and that in the observation group was significantly lower(P<0.05).After treatment,the levels of CD_(19)+B cells,immunoglobulin(Ig)G,IgM,IgA and tumor necrosis factor-α(TNF-α)in the two groups were significantly lower,the levels of complement C3,complement C4 and interleukin-2(IL-2)in the two groups were significantly higher,and those in the observation group were significantly better(P<0.05).After treatment,the levels of 24 h urinary protein(24 hUpr),urinaryβ_(2)-microglobulin and urinary red blood cell count in the two groups were significantly lower,and those in the observation group were significantly lower(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(29.55%vs.19.57%,P>0.05).Conclusion Telitacicept combined with standard regimen in the t

关 键 词：系统性红斑狼疮 活动性狼疮肾炎 免疫功能 泰它西普 临床疗效 

分 类 号：R969.4[医药卫生—药理学] R976[医药卫生—药学]