摘要
目的评价小剂量甲泼尼龙联合甲氨蝶呤和羟氯喹治疗轻中度系统性红斑狼疮(SLE)患者的疗效及安全性。方法96例轻到中度系统性红斑狼疮患者,按患者就诊时间分为观察组和对照组,各48例。两组患者均给予甲氨蝶呤和羟氯喹;对照组加用双氯芬酸钠(75 mg/次,2次/d),观察组加用甲泼尼龙(4 mg/次,2次/d),两组均治疗12周。比较两组患者的疗效和不良反应发生情况。结果两组患者经过12周的治疗,观察组有效率为91.67%,明显高于对照组的64.58%,差异有统计学意义(P<0.05)。治疗前,两组患者间狼疮疾病活动指数(SLEDAI)、红细胞沉降率(ESR)、C反应蛋白(CRP)、补体C3水平相比,差异均无统计学意义;治疗后,两组患者的SLEDAI积分、ESR、CRP、补体C3水平均较治疗前明显改善,同组治疗前后比较差异有统计学意义(P<0.05);且观察组比对照组改善更明显,两组间各指标相比差异均具有统计学意义(P<0.05)。治疗后两组相比,观察组的不良反应发生率低,差异均有统计学意义(P<0.05)。结论小剂量甲泼尼龙联合甲氨蝶呤和羟氯喹治疗系统性红斑狼疮疗效显著,安全性高,值得推广。
Objective To investigate the clinical effect and safety of low-dose methylprednisolone combined with methotrexate and hydroxychloroquine in treatment of systemic lupus erythematosus （SLE）. Methods 96 patients with mild-to-moderate systemic lumus erythematosus in our hospital from April 2012 to April 2017 were divide into control group and observation group according to visitiving time, 48 cases in each group. All the patients were given hydroxychloroquine and methotrexate therapy, while the control group was given meloxicam （7.5 mg/time, 2 times/d） in addition, and the observation group was given methylprednisolone （4 mg/time, 2 times/d） in addition. The clinical efficacy and adverse events were compared after the treatment. Results The score of SLEDAI, CRP, ESR, levels of C3 after the treatment were significantly better as compared with that before treatment in both groups （P 〈 0.05）. And the efficiency and incidence of adverse reactions of the observation groups were significantly better than the control group （P 〈 0.05）. Conelusion Low-dose methylprednisolone combined with methotrexate and hydroxychloroquine on treating systemic lupus erythematosus was safe, effective and worth to be prometed in clinical.
作者
牛东燕
梁卓文
杨元花
NIU Dongyan;LIANG Zhuowen;YANG Yuanhua(Rheumatology Department, Xi＇an 630 Hospital, Xi＇an 710089, China;Spine Surgery Department, Xijing Hospital, Xi＇an 710032, China)
出处
《药物评价研究》
CAS
2018年第4期611-614,共4页
Drug Evaluation Research
关键词
甲泼尼龙
系统性红斑狼疮
甲氨蝶呤
安全性
Methylprednisolone
systemic lupus erythematosus
methotrexate
safety
