利妥昔单抗联合他克莫司及雷公藤多苷治疗狼疮性肾炎的临床研究  

Clinical study of Rituximab combined with Tacrolimus and Tripterygium wilfordii polyglycoside in the treatment of lupus nephritis

作　　者：宗海涛 李亚宁 林雪菲 ZONG Haitao;LI Yaning;LIN Xuefei(Department of Nephrology,Jiujiang Traditional Chinese Medicine Hospital,Jiujiang,Jiangxi 332000,China)

机构地区：[1]江西省九江市中医医院肾内科,江西九江332000

出　　处：《检验医学与临床》2024年第4期459-462,共4页Laboratory Medicine and Clinic

基　　金：江西省中医药管理局科技计划项目(2022A200)。

摘　　要：目的观察利妥昔单抗联合他克莫司及雷公藤多苷治疗狼疮性肾炎(LN)的临床疗效。方法选择该院肾内科2022年1月至2023年1月收治的80例LN患者为研究对象,按照随机数字表法分为研究组和对照组,各40例。对照组给予利妥昔单抗治疗,研究组在对照组治疗基础上,联合他克莫司及雷公藤多苷治疗,连续治疗4周。比较两组临床疗效、生化指标、自身抗体阳性率、不良反应发生情况。结果研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组24 h尿蛋白定量、血肌酐水平降低,血清清蛋白、补体(C3)、C4水平升高,且观察组改善更佳,差异有统计学意义(P<0.05);治疗后,研究组抗核抗体、抗双链DNA抗体阳性率低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论利妥昔单抗联合他克莫司及雷公藤多苷可多靶点治疗LN,调节各项生化指标,控制病情,获得更好的治疗效果,且中西医并重治疗,具有一定安全性。Objective To observe the clinical efficacy of Rituximab combined with Tacrolimus and Tripterygium wilfordii polyglycoside in the treatment of lupus nephritis(LN).Methods A total of 80 LN patients admitted to the Department of Nephrology in Jiujiang Traditional Chinese Medicine Hospital from January 2022 to January 2023 were selected as the study subjects.They were divided into experimental group and control group according to random number table method,with 40 patients in each group.Patients in the control group were treated with Rituximab.On this basis,patients in the experimental group were treated with Tacrolimus and Tripterygium wilfordii polyglycoside for 4 consecutive weeks.The clinical efficacy,biochemical indicators,positive rate of autoantibody and the rate of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the experimental group was higher than that in the control group,with statistically significant difference(P<0.05).After treatment,24 hours of urinary protein quantification and serum creatinine(Cr)level decreased,while serum albumion,complement(C3)and C4 level increased in both groups,and the experimental group showed better improvement,with statistically significant difference(P<0.05).After treatment,the positive rates of antinuclear antibody and anti-double stranded DNA in the experimental group were lower than those in the control group,with statistically significant difference(P<0.05).There was no statistically significant difference on the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Rituximab combi ned with Tacrolimus and Tripterygium wilfordii polyglycoside can treat LN with multiple targets,regulate various biochemical indicators,control the disease,and obtain better therapeutic effect.Combined Chinese and western medicine treatment,has a certain safety.

关 键 词：利妥昔单抗 狼疮性肾炎 雷公藤多苷 他克莫司 抗核抗体 抗双链DNA抗体 

分 类 号：R256.5[医药卫生—中医内科学]