小剂量利妥昔单抗联合泼尼松治疗难治性狼疮性肾炎的效果  

Effectiveness of Low-dose Rituximab Combined with Prednisone in the Treatment of Refractory Lupus Nephritis

作　　者：许燕珊 Xu Yanshan(Department of Pharmacy,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,Guangdong Province,China)

机构地区：[1]汕头大学医学院第二附属医院药学部,广东汕头515041

出　　处：《中外医药研究》2024年第33期51-53,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨小剂量利妥昔单抗联合泼尼松治疗难治性狼疮性肾炎(LN)的效果。方法:选取2022年1月—2024年1月汕头大学医学院第二附属医院收治的100例难治性LN患者为研究对象,随机分为对照组和观察组,各50例。对照组给予泼尼松治疗,观察组在此基础上加用小剂量利妥昔单抗治疗。比较两组临床疗效,24 h尿蛋白定量(24 h Up),红细胞沉降率(ESR)和补体C3、补体C4、炎性因子水平,不良反应发生情况。结果:观察组治疗总有效率高于对照组(P=0.029);治疗后,两组24hUp、ESR水平降低,补体C3、补体C4水平升高,观察组24hUp、ESR水平低于对照组,补体C3、补体C4水平高于对照组(P<0.05);治疗后,两组白细胞介素-6、白细胞介素-12、白细胞介素-18水平降低,观察组低于对照组(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:小剂量利妥昔单抗联合泼尼松治疗难治性LN效果确切,能够有效改善炎性反应,减轻肾脏损伤,恢复补体系统平衡,安全有效。Objective:To investigate the effect of low-dose rituximab combined with prednisone in the treatment of refractory lupus nephritis(LN).Methods:One hundred patients with refractory LN admitted to the Second Affiliated Hospital of Shantou University Medical College from January 2022 to January 2024 were selected as the study subjects,and randomly divided into the control group and the observation group,each with fifty cases.The control group was treated with prednisone,and the observation group was treated with low-dose rituximab on this basis.The two groups were compared in terms of clinical efficacy,24 h urine protein quantification(24 h Up),erythrocyte sedimentation rate(ESR)and levels of complement C3,complement C4,inflammatory factor,and the occurrence of adverse reactions.Results:The total effective rate of treatment in the observation group was higher than that in the control group(P=0.029);after treatment,the levels of 24 h Up and ESR decreased and the levels of complement C3 and complement C4 increased in the two groups;the levels of 24 h Up and ESR in the observation group were lower than those in the control group,and the levels of complement C3 and complement C4 were higher than those in the control group(P<0.05);after treatment,the levels of interleukin-6,interleukin-12 and interleukin-18 decreased in both groups,and the observation group was lower than the control group(P<0.05);the difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion:Low-dose rituximab combined with prednisone is effective in the treatment of refractory LN,which can effectively improve the inflammatory reaction,reduce renal injury,restore the balance of complement system,safe and effective.

关 键 词：小剂量利妥昔单抗 泼尼松 难治性狼疮性肾炎 白细胞介素-6 白细胞介素-12 白细胞介素-18 

分 类 号：R593.242[医药卫生—内科学]