利妥昔单抗辅助疗法对系统性红斑狼疮患者SLEDAI评分及T细胞亚群水平的影响  

The effect of rituximab adjuvant therapy on SLEDAI score and T cell subset levels in patients with systemic lupus erythematosus

作　　者：陈旭 李艳菊 谢静 陈曦 刘媛媛 马凤莲 张明珠 严晓旭 郭东更[1,2] CHEN Xu;LI Yan-ju;XIE Jing(Department of Rheumatology and Immunology,Ningxia Hui Autonomous Region People's Hospital,Yinchuan 750001,China)

机构地区：[1]宁夏回族自治区人民医院风湿免疫科,750001 [2]宁夏自身免疫性疾病精准医学重点实验室,750001

出　　处：《中国现代药物应用》2025年第5期96-99,共4页Chinese Journal of Modern Drug Application

基　　金：宁夏自然科学基金(项目编号:2022AAC03380);宁夏回族自治区人民医院培育振兴项目(项目编号:202104)。

摘　　要：目的探讨系统性红斑狼疮(SLE)患者治疗中辅助应用利妥昔单抗的价值。方法130例SLE患者,利用“随机数字表法”分为观察组与对照组,每组65例。观察组实施利妥昔单抗治疗,对照组实施他克莫司治疗。对比两组临床疗效、临床指标、T细胞亚群水平、不良反应发生率、免疫功能。结果观察组总有效率为96.92%,比对照组的84.62%高(P<0.05)。治疗后,观察组系统性红斑狼疮疾病活动度评分表(SLEDAI)评分(5.11±1.02)分、英国狼疮评估组(BILAG)评分(10.21±1.02)分比对照组的(10.28±3.12)、(15.24±1.66)分低(P<0.05)。治疗后,观察组CD4^(+)(43.85±6.21)%、CD4^(+)/CD8^(+)(1.17±0.18)比对照组的(39.33±6.14)%、(1.00±0.16)高,CD8^(+)(37.31±4.04)%比对照组的(39.17±4.11)%低(P<0.05)。观察组出现不良反应发生率为6.15%,比对照组的18.46%低(P<0.05)。治疗后,观察组免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)比对照组低(P<0.05)。结论SLE患者治疗中辅助应用利妥昔单抗可改善免疫功能与T淋巴细胞亚群,且治疗安全性及有效性较高,对提高病情控制效果有积极作用,值得借鉴。Objective To explore the value of rituximab adjuvant therapy on SLEDAI score and T cell subset levels in patients with systemic lupus erythematosus(SLE).Methods A total of 130 SLE patients were divided into observation group and control group using the"random number table method",each with 65 cases.The observation group was treated with rituximab,and the control group was treated with tacrolimus.Comparison of the clinical efficacy,clinical indicators,T cell subset levels,incidence of adverse reactions,and immune function between the two groups.Results The total effective rate of 96.92%in the observation group was higher than 84.62%in the control group(P<0.05).After treatment,the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score and British Isles Lupus Assessment Group(BILAG)score were(5.11±1.02)and(10.21±1.02)points in the observation group,which were lower than(10.28±3.12)and(15.24±1.66)points in the control group(P<0.05).After treatment,the observation group had CD4^(+)of(43.85±6.21)%and CD4^(+)/CD8^(+)of(1.17±0.18),which were higher than(39.33±6.14)%and(1.00±0.16)in the control group;the observation group had a lower CD8^(+)of(37.31±4.04)%than(39.17±4.11)%in the control group(P<0.05).The incidence of adverse reactions of 6.15%in the observation group was lower than 18.46%in the control group(P<0.05).After treatment,the immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)in the observation group were lower than those in the control group(P<0.05).Conclusion Adjuvant use of rituximab in the treatment of SLE patients can improve immune function and T lymphocyte subsets,and has high treatment safety and effectiveness,which has a positive effect on improving disease control and is worthy of reference.

关 键 词：利妥昔单抗 辅助疗法 系统性红斑狼疮 系统性红斑狼疮疾病活动度评分表评分 T细胞亚群 

分 类 号：R593.241[医药卫生—内科学]