摘要
目的探讨免疫球蛋白G4(recombinant immunoglobulin G4,IgG4)相关性疾病(immunoglobulin-g4 related disease,IgG4-RD)患者联合应用糖皮质激素与免疫抑制剂的临床疗效。方法回顾性分析72例2015年4月—2022年11月在福建医科大学附属第二医院进行治疗的IgG4-RD患者一般临床资料,根据患者应用治疗方式差异分为对照组(n=36)和观察组(n=36)。对照组应用糖皮质激素治疗,观察组采用糖皮质激素联合免疫抑制剂治疗。对比两组治疗后不同时间患者Ig G4-RD疾病反应指数(Ig G4-RD disease response index,IgG4-RD RI)、疾病缓解效果、治疗期间累积复发情况、复发时间、复发时糖皮质激素应用剂量与糖皮质激素累积用量以及治疗期间不良事件发生情况。结果治疗1个月后两组疾病缓解率差异无统计学意义(P>0.05);治疗3、6个月后及治疗12个月后观察组患者疾病缓解率均明显较对照组高(P<0.05)。治疗后观察组患者IgG4-RD R1评分均显著低于对照组(P<0.05)。治疗期间两组对比,观察组患者累积复发率显著更低,疾病复发时间更长、复发时糖皮质激素应用剂量与糖皮质激素累积用量均显著更少(P<0.05)。治疗期间两组患者不良事件总发生率比较,差异无统计学意义(P>0.05)。结论IgG4-RD患者接受糖皮质激素与免疫抑制剂联合治疗能够取得更加显著的疾病缓解效果,而有助于降低复发风险,并联合用药不会造成用药不良事件增加,疗效确切且安全可靠。
Objective To investigate the clinical efficacy of glucocorticoid combined with immunosuppressant in patients with immunoglobulin G4(IgG4)related disease(IgG4-RD).Methods The general clinical data of 72 patients with IgG4-RD who were treated in the Second Affiliated Hospital of Fujian Medical University from April 2015 to November 2022 were analyzed retrospectively.According to the differences in the treatment methods used by patients,the control group(n=36)and the observation group(n=36)were treated with glucocorticoid,and the observation group(n=36)were treated with glucocorticoid combined with immunosuppressant,The IgG4-RD disease response index(IgG4-RD RI),disease remission effect,cumulative recurrence during treatment,recurrence time,glucocorticoid dosage and cumulative glucocorticoid dosage during recurrence,and adverse events during treatment were compared before and after treatment.Results There was no significant difference in the disease remission rate between the two groups after one month of treatment(P>0.05).The disease remission rate in the observation group was significantly higher than that in the control group after three months,six months and 12 months of treatment(P<0.05).After treatment,the IgG4-RD R1 scores of patients in the observation group were significantly lower than those in the control group(P<0.05).During the treatment,compared with the two groups,the cumulative recurrence rate of patients in the observation group was significantly lower,the disease recurrence time was longer,and the dosage of glucocorticoid and the cumulative dosage of glucocorticoid in the recurrence were significantly lower(P<0.05).There was no significant difference in the total incidence of adverse events between the two groups during treatment(P>0.05).Conclusion The combination of glucocorticoid and immunosuppressant in the treatment of IgG4-RD patients can achieve more significant disease remission effect,and help to reduce the risk of recurrence.Moreover,the combination of glucocorticoid and immunosuppressant
作者
徐思斌
周明宣
XU Sibin;ZHOU Mingxuan(Department of General Medicine,the Second Attached Hospital of Fujian Medical University,Quanzhou Fujian 362000,China)
出处
《中国卫生标准管理》
2023年第10期128-132,共5页
China Health Standard Management
