早期应用贝利尤单抗治疗系统性红斑狼疮患者的效果及对激素减量的影响分析  

The effect analysis of early application of belimumab in the treatment of patients with systemic lupus erythematosus and its impact on hormone reduction

作　　者：欧阳楚君[1] 卢瑞荣 韦锋[1] 梁灼源[1] 郭静静[1] 冯明亮[1] OU-YANG Chu-jun;LU Rui-rong;WEI Feng(Rheumatology and Immunology Department,Jiangmen Central Hospital,Jiangmen 529000,China)

机构地区：[1]江门市中心医院风湿免疫科,529000

出　　处：《中国现代药物应用》2024年第2期40-45,共6页Chinese Journal of Modern Drug Application

摘　　要：目的观察早期应用(诱导缓解期3个月内)贝利尤单抗治疗系统性红斑狼疮(SLE)的效果及对激素减量的影响。方法选取83例使用贝利尤单抗治疗的SLE患者,两组均使用甲泼尼龙及吗替麦考酚酯作为背景用药。根据患者诱导缓解期开始使用贝利尤单抗的时间分为早期组(35例)和对照组(48例)。早期组在诱导缓解期≤3个月时开始使用贝利尤单抗治疗,对照组在诱导缓解期>3个月时开始使用贝利尤单抗治疗。比较两组血常规指标[白细胞计数(WBC)、中性粒细胞计数(Neut)、淋巴细胞计数(Lym)、血小板计数(PLT)、血红蛋白(Hb)]、肝肾功能指标[白蛋白(ALB)、血肌酐(SCr)]和血沉(ESR)水平、免疫功能指标[免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、球蛋白、补体C3、补体C4]、激素减量值和系统性红斑狼疮疾病活动指数(SLEDAI-2000评分)及主要器官损害情况。结果早期组治疗24周时的Neut水平(4.39±1.59)×10^(9)/L明显低于对照组的(6.56±3.09)×10^(9)/L,治疗12周时的Lym水平(1.73±0.49)×10^(9)/L、Hb水平(122.85±15.38)g/L和治疗24周时的Lym水平(1.59±0.49)×10^(9)/L、Hb水平(123.20±16.70)g/L明显高于对照组的(1.48±0.42)×10^(9)/L、(105.89±16.91)g/L和(1.38±0.34)×10^(9)/L、(103.42±25.63)g/L,有统计学差异(P<0.05)。早期组治疗24周时的ALB水平(41.20±3.07)g/L明显高于对照组的(38.50±6.06)g/L,治疗12周时的SCr水平(55.46±16.40)μmol/L和治疗24周时的SCr水平(54.79±16.15)μmol/L明显低于对照组的(74.46±24.21)、(69.34±20.95)μmol/L,治疗12周时的ESR水平(24.44±10.63)mm/h明显低于对照组的(32.37±11.21)mm/h,有统计学差异(P<0.05)。早期组治疗12和24周时的IgG和IgA水平明显低于对照组,治疗12周时的球蛋白水平明显低于对照组,治疗12和24周时的C3水平明显高于对照组,有统计学差异(P<0.05)。治疗12和24周时,早期组的激素减量值(60.49±27.42)、(68.23±22.12)mg明显高于Objective To observe the effects of early application(within 3 months of induced remission)of belimumab in the treatment of systemic lupus erythematosus(SLE)and its impact on hormone reduction.Results 83 SLE patients treated with belimumab was selected,and methylprednisolone and mycophenolate mofetil were used as background drugs in both groups.The patients were divided into early group(35 cases)and control group(48 cases)based on the time they began using belimumab during the induced remission period.Patients in the early group started using belimumab after an induced remission period of≤3 months,and patients in the control group started using belimumab after an induced remission period of>3 months.Both groups were compared in terms of blood routine indexes[white blood cell count(WBC),neutrophil count(Neut),lymphocyte count(Lym),platelet count(PLT),hemoglobin(Hb)],liver and kidney function indexes[albumin(ALB),serum creatinine(SCr)],erythrocyte sedimentation rate(ESR)levels,immune function indexes[immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM),globulin,complement C3,complement C4],hormone reduction,Systemic Lupus Erythematosus Disease Activity Index(SLEDAI-2000 score)and major organ damage.Results At 24 weeks of treatment,Neut of(4.39±1.59)×10^(9)/L in the early group was obviously lower than(6.56±3.09)×10^(9)/L in the control group;Lym and Hb were(1.73±0.49)×10^(9)/L and(122.85±15.38)g/L at 12 weeks of treatment,and(1.59±0.49)×10^(9)/L and(123.20±16.70)g/L at 24 weeks of treatment,which were significantly higher than(1.48±0.42)×10^(9)/L,(105.89±16.91)g/L and(1.38±0.34)×10^(9)/L,(103.42±25.63)g/L in the control group;there was statistical difference(P<0.05).In early group,ALB level of(41.20±3.07)g/L at 24 weeks of treatment was significantly higher than(38.50±6.06)g/L in the control group;SCr level was(55.46±16.40)μmol/L at 12 weeks of treatment and(54.79±16.15)μmol/L at 24 weeks of treatment,which were significantly lower than(74.46±24.21)and(69.34±20.95)μmol/L in t

关 键 词：贝利尤单抗 系统性红斑狼疮 诱导缓解期 激素减量 

分 类 号：R593.241[医药卫生—内科学]