吗替麦考酚酯联合甲泼尼龙对系统性红斑狼疮患者免疫功能、β-抑制蛋白质1水平及临床疗效的影响  

Impacts of Mycophenolate Mofetil Combined with Methylprednisolone on Immune Function,β-arrestin1 Level and Clinical Efficacy in Patients with Systemic Lupus Erythematosus

作　　者：李庆娜 王晓寒[1] 董卫红[1] LI Qing-na;WANG Xiao-han;DONG Wei-hong(Department of Rheumatology and Immunology,Puyang City,Anyang District Hospital,Anyang 455000,China)

机构地区：[1]濮阳市安阳地区医院风湿免疫科,安阳455000

出　　处：《中国合理用药探索》2023年第12期99-105,共7页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划项目(LHGY20200815)。

摘　　要：目的:探讨吗替麦考酚酯联合甲泼尼龙对系统性红斑狼疮(SLE)患者免疫功能、β-抑制蛋白质1(β-arrestin1)水平及临床疗效的影响。方法:选取2020年4月~2022年7月期间某院收治的74例SLE患者作为研究对象,按照随机数字表法分为观察组和对照组,每组37例。对照组给予甲泼尼龙片治疗,观察组在对照组基础上加用吗替麦考酚酯分散片,两组均治疗12周。比较两组患者免疫功能(补体C3、补体C4、IgG、IgA、IgM)、血常规指标[白细胞计数(WBC)、红细胞沉降率(ESR)、血红蛋白(Hb)、血小板计数(PLT)]、肾功能指标(血清白蛋白、血肌酐、24h尿蛋白)、系统性红斑狼疮疾病活动指数(SLEDAI)、血清β-arrestin1水平、临床疗效及不良反应发生情况。结果:治疗后,两组患者补体C3和补体C4水平均升高,且观察组高于对照组(P<0.05);IgG、IgA、IgM水平均降低,且观察组低于对照组(P<0.05);WBC、Hb、PLT水平均升高,且观察组高于对照组(P<0.05);ESR均降低,且观察组低于对照组(P<0.05);血清白蛋白水平均升高,且观察组高于对照组(P<0.05);血肌酐和24h尿蛋白水平均降低,且观察组低于对照组(P<0.05);SLEDAI评分和血清β-arrestin1水平均降低,且观察组低于对照组(P<0.05)。观察组治疗总有效率(91.89%)高于对照组(72.97%,P<0.05);两组不良反应总发生率比较无统计学差异(P>0.05)。结论:吗替麦考酚酯联合甲泼尼龙治疗可显著改善SLE患者的免疫功能和肾功能,降低SLE活动度,且未增加不良反应的发生风险。Objective:To investigate the impacts of mycophenolate mofetil combined with methylprednisolone on the efficacy,immune function andβ-arrestin1 level in patients with systemic lupus erythematosus(SLE).Methods:A total of 74 SLE patients admitted to a hospital from April 2020 to July 2022 were selected as research subjects,and assigned into the observation group and the control group using random number table method,with 37 cases in each group.The control group was given methylprednisolone tablets,and the observation group was given mycophenolate dispersive tablets on the basis of the control group.The two groups were treated for 12 weeks.The immune function(complement C3,complement C4,IgG,IgA,IgM),hematology indicators[white blood cell count(WBC),erythrocyte sedimentation rate(ESR),hemoglobin(Hb),platelet count(PLT)],renal function indicators(serum albumin,serum creatinine,24h urine protein),systemic lupus erythematosus disease activity index(SLEDAI),serumβ-arrestin1 level,clinical efficacy and the incidence of adverse reactions were compared between the two groups.Results:After treatment,the levels of complement C3 and C4 were increased in both groups,and those in the observation group were higher than that in the control group(P<0.05).The levels of IgG,IgA and IgM were decreased in both groups,and those in the observation group were lower than that in the control group(P<0.05).The levels of WBC,Hb and PLT were all increased,and those in the observation group were higher than that in the control group(P<0.05);ESR were decreased in both groups,and those in the observation group were lower than that in the control group(P<0.05).The level of serum albumin were increased in both groups,and those in the observation group was higher than that in the control group(P<0.05).The level of serum creatinine and 24h urinary protein were decreased in both groups,and those in the observation group were lower than that in the control group(P<0.05).SLEDAI score and level of serumβ-arrestin 1 were decreased in both groups,and thos

关 键 词：吗替麦考酚酯 甲泼尼龙 系统性红斑狼疮 免疫功能 β-抑制蛋白质1 

分 类 号：R593.241[医药卫生—内科学]