环孢素A对难治性狼疮性肾炎的治疗效果研究  

Study on the therapeutic effect of cyclosporin A for refractory lupus nephritis

作　　者：孙娟娟 SUN Juan-juan(Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院,276400

出　　处：《中国实用医药》2024年第8期15-18,共4页China Practical Medicine

摘　　要：目的探究环孢素A对难治性狼疮性肾炎的治疗效果。方法120例难治性狼疮性肾炎患者为观察对象,按照治疗方案不同将其分为参照组(60例)、研究组(60例)。参照组开展常规激素治疗,研究组则在常规激素基础上加用环孢素A治疗。对比两组患者的治疗效果、不良反应发生率及治疗前后肾功能指标、免疫功能指标和T淋巴细胞亚群、炎症因子。结果研究组患者治疗总有效率95.00%高于参照组的81.67%(P<0.05)。治疗后,两组患者尿微量白蛋白(MAU)、血β_(2)微球蛋白、尿β_(2)微球蛋白及24 h尿蛋白定量均较治疗前下降,且研究组MAU(65.18±10.33)mg/L、血β_(2)微球蛋白(2.41±0.21)mg/L、尿β_(2)微球蛋白(0.28±0.07)mg/L、24 h尿蛋白定量(0.54±0.11)g/24 h低于参照组的(125.39±10.87)mg/L、(3.72±0.23)mg/L、(0.53±0.06)mg/L、(0.95±0.13)g/24 h(P<0.05)。治疗后,两组患者免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)及CD3+、CD4+/CD8+均较治疗前升高,且研究组CD3+(60.13±4.24)%、CD4+/CD8+(1.80±0.11)、IgA(2.68±0.35)g/L、IgM(1.45±0.19)g/L、IgG(15.54±1.32)g/L均高于参照组的(43.21±3.45)%、(1.43±0.13)、(1.81±0.32)g/L、(1.09±0.15)g/L、(10.13±1.46)g/L(P<0.05)。治疗后,两组患者肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)水平均较治疗前下降,且研究组TNF-α(21.12±3.24)ng/L、hs-CRP(5.16±1.09)mg/L、IL-8(20.11±3.05)μg/L、IL-6(11.75±4.02)ng/L均低于参照组的(28.31±4.05)ng/L、(8.12±1.05)mg/L、(25.24±3.06)μg/L、(20.12±4.25)ng/L(P<0.05)。研究组患者不良反应发生率8.33%与参照组的10.00%相比,差异不显著(P>0.05)。结论环孢素A用于难治性狼疮性肾炎的治疗中可提升疗效,并改善患者的肾功能、免疫功能、炎症反应,效果显著。Objective To explore the therapeutic effect of cyclosporin A for refractory lupus nephritis.Methods 120 patients with refractory lupus nephritis were selected as observation subjects.According to different treatment plans,they were divided into the reference group(60 cases)and the study group(60 cases).The reference group conducted conventional hormone therapy,and the study group added cyclosporin A to the conventional hormone therapy.The therapeutic effect and incidence of adverse reactions,and renal function indicators,immune function indicators,T-lymphocyte subsets,and inflammatory factors before and after treatment of the two groups were compared.Results The total effective rate of the study group was 95.00%,which was higher than 81.67%of the reference group(P<0.05).After treatment,the microalbuminuria(MAU),bloodβ_(2) microglobulin,urinaryβ_(2) microglobulin and 24 h urinary protein decreased in both groups compared with those before treatment;MAU in the study group was(65.18±10.33)mg/L,the bloodβ_(2) microglobulin was(2.41±0.21)mg/L,the urinaryβ_(2) microglobulin was(0.28±0.07)mg/L,and the 24 h urinary protein was(0.54±0.11)g/24 h,which were lower than(125.39±10.87)mg/L,(3.72±0.23)mg/L,(0.53±0.06)mg/L,and(0.95±0.13)g/24 h in the reference group(P<0.05).After treatment,the immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG),CD3+,and CD4+/CD8+increased in both groups compared+with those before treatment;the study group had CD3 of(60.13±4.24)%,CD4+/CD8+of(1.80±0.11),IgA of(2.68±0.35)g/L,IgM of(1.45±0.19)g/L,and IgG of(15.54±1.32)g/L,which were higher than(43.21±3.45)%,(1.43±0.13),(1.81±0.32)g/L,(1.09±0.15)g/L,and(10.13±1.46)g/L in the reference group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP),interleukin-8(IL-8),and interleukin-6(IL-6)in both groups decreased compared with those before treatment;the study group had TNF-αof(21.12±3.24)ng/L,hs-CRP of(5.16±1.09)mg/L,IL-8 of(20.11±3.05)μg/L,and IL-6 of(11.

关 键 词：环孢素A 难治性狼疮性肾炎 免疫功能 肾功能 

分 类 号：R593.242[医药卫生—内科学]