甲泼尼龙辅助沙利度胺治疗SLE难治性皮疹的有效性及安全性分析  

Efficacy and safety of methylprednisolone assisted with thalidomide in the treatment of refractory rash in SLE

作　　者：谭电台 汤涌 Tan Dian-tai;Tang Yong(Department of Internal Medicine,Yugan People's Hospital,Shangrao 335100,Jiangxi,China)

机构地区：[1]余干县人民医院内科,江西上饶335100

出　　处：《四川生理科学杂志》2024年第12期2776-2778,共3页

摘　　要：目的:探究甲泼尼龙辅助沙利度胺治疗系统性红斑狼疮(Systemic lupus erythematosus,SLE)难治性皮疹的临床应用效果。方法:收集2022年1月至2023年10月我院收治的SLE难治性皮疹患者69例为研究对象,以治疗方法的不同将其分为对照组32例与联合组37例。对照组给予单一的沙利度胺治疗,联合组在对照组的基础上加以甲泼尼龙辅助治疗。比较治疗前后两组患者的临床有效性、疾病活动度及免疫功能,并记录治疗期间两组患者不良反应发生情况。结果:联合组总有效性为94.59%(25/37)显著高于对照组的78.13%(25/32)(P<0.05);治疗后,两组患者系统性红斑狼疮疾病活动度评分(Systemic Lupus Erythematosus Disease Activity Index,SLEDAI)均低于治疗前,且联合组显著低于对照组(P<0.05);治疗3 m后,两组患者补体C3、补体C4均高于治疗前,免疫球蛋白(Immunoglobulins,Ig)A、IgG、IgM均低于治疗前,且联合组改变幅度均高于对照组(P<0.05);治疗期间,两组患者安全性比较,差异无统计学意义(P>0.05)。结论:相较于单一的沙利度胺治疗,甲泼尼龙辅助联合沙利度胺治疗SLE难治性皮疹患者疗效更为显著,可改善患者疾病活动度与免疫功能,且具有一定安全性。Objective:To investigate the clinical application effect of methylprednisolone assisted with thalidomide in the treatment of refractory rash in systemic lupus erythematosus(SLE).Methods:From January 2022 to October 2023,69 patients with SLE and refractory rashes admitted to the hospital were selected as the research subjects.They were divided into the control group(32 cases)and the combination group(37 cases)according to different treatment methods.The former was treated with thalidomide,and the latter was treated with methylprednisolone on this basis.Compare the clinical efficacy,disease activity,and immune function of two groups of patients before and after treatment,and record the occurrence of adverse reactions during the treatment period.Results:The total effective rates in the combination group and the control group were 94.59%(25/37)and 78.13%(25/32),and the former was significantly higher(P<0.05).After treatment,Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)scores of both groups were lower than those before treatment,and scores of the combination group were significantly lower(P<0.05).After 3 months of treatment,there were increases in the levels of complement C3 and complement C4,and decreases in the levels of immunoglobulin(Ig)A,IgG and IgM in both groups.The changes were greater in the combination group(P<0.05).In terms of safety,the two groups were comparable(P>0.05).Conclusion:Compared with treatment with thalidomide alone,combined treatment with methylprednisolone and thalidomide is more effective for patients with SLE and refractory rashes,which can improve disease activity and immune function,with safety.

关 键 词：系统性红斑狼疮 难治性皮疹 沙利度胺 甲泼尼龙 临床有效性 

分 类 号：R593.241[医药卫生—内科学]