他克莫司与环磷酰胺联合免疫吸附法治疗老年系统性红斑狼疮肾炎的疗效及对炎性和免疫功能指标的影响
发布时间：2019-03-01 11:11
【摘要】：目的对比他克莫司与环磷酰胺配合免疫吸附法治疗老年系统性红斑狼疮肾炎(SLEN)的疗效及其对炎性和免疫功能指标的影响。方法老年SLEN患者86例,随机分为他克莫司+免疫吸附治疗组(他克莫司组)和环磷酰胺+免疫吸附治疗组(环磷酰胺组),每组各43例。分别观察两组患者的治疗效果并检测炎症反应因子和免疫功能指标的改变。结果治疗后他克莫司组完全缓解(CR)和部分缓解(PR)患者分别为32例和8例,总体有效率为93.02%,显著高于环磷酰胺组(74.42%,χ~2=5.460,P=0.019);且他克莫司组的不良反应发生率为11.62%%,也显著低于环磷酰胺组(30.23%,χ~2=4.497,P=0.034)。此外,尽管治疗后两组患者的肾功能指标尿蛋白、尿素氮、肌酐和白蛋白、抗核抗体、白细胞介素(IL)-6、IL-8、IL-12、IL-16和肿瘤坏死因子(TNF)-α及免疫功能指标IgA、IgM、IgG、补体C3和C4及T细胞亚群CD3~+、CD4~+、CD8~+和CD4~+/CD8~+均得以改善(P0.05),但是他克莫司组患者的上述各项指标的改善程度亦明显优于环磷酰胺组(P0.05)。结论他克莫司联合免疫吸附法对老年狼疮肾炎具有良好的临床疗效,且能够明显改善机体的炎症反应和免疫功能。
[Abstract]:Aim to compare the efficacy of tacrolimus and cyclophosphamide combined with immunoadsorption in the treatment of elderly patients with systemic lupus erythematosus nephritis (SLEN) and its effect on inflammatory and immune function. Methods 86 elderly patients with SLEN were randomly divided into tacrolimus immunoadsorption group (tacrolimus group) and cyclophosphamide immunoadsorption treatment group (cyclophosphamide group) with 43 cases in each group. The therapeutic effects of the two groups were observed, and the changes of inflammatory reaction factor and immune function index were detected. Results after treatment, there were 32 patients with complete remission of (CR) and 8 patients with partial remission (PR) in tacrolimus group. The overall effective rate was 93.02%, which was significantly higher than that in cyclophosphamide group (74.42%, 蠂 ~ 2 / 5.460, P = 0.019). The incidence of adverse reactions in tacrolimus group was 11.62%, which was significantly lower than that in cyclophosphamide group (30.23%, 蠂 ~ 2 / 4.497, P = 0.034). In addition, although after treatment, urinary protein, urea nitrogen, creatinine and albumin, antinuclear antibodies, interleukin-6 (IL)-6), interleukin-8 (IL-8), and interleukin-12 (IL-12) were measured in both groups. IL-16, tumor necrosis factor (TNF)-伪, IgA,IgM,IgG, complement C3 and C4 and T cell subsets CD3~, CD4~, CD8~ and CD4~ / CD8~ were improved (P0.05). However, the improvement of the above indexes in the tacrolimus group was significantly better than that in the cyclophosphamide group (P0.05). Conclusion Tacrolimus combined with immunoadsorption has a good clinical effect on lupus nephritis in the elderly, and can significantly improve the inflammatory response and immune function of the body.
【作者单位】： 右江民族医学院附属医院肾内科;
【分类号】：R593.242
，
本文编号：2432377
[Abstract]:Aim to compare the efficacy of tacrolimus and cyclophosphamide combined with immunoadsorption in the treatment of elderly patients with systemic lupus erythematosus nephritis (SLEN) and its effect on inflammatory and immune function. Methods 86 elderly patients with SLEN were randomly divided into tacrolimus immunoadsorption group (tacrolimus group) and cyclophosphamide immunoadsorption treatment group (cyclophosphamide group) with 43 cases in each group. The therapeutic effects of the two groups were observed, and the changes of inflammatory reaction factor and immune function index were detected. Results after treatment, there were 32 patients with complete remission of (CR) and 8 patients with partial remission (PR) in tacrolimus group. The overall effective rate was 93.02%, which was significantly higher than that in cyclophosphamide group (74.42%, 蠂 ~ 2 / 5.460, P = 0.019). The incidence of adverse reactions in tacrolimus group was 11.62%, which was significantly lower than that in cyclophosphamide group (30.23%, 蠂 ~ 2 / 4.497, P = 0.034). In addition, although after treatment, urinary protein, urea nitrogen, creatinine and albumin, antinuclear antibodies, interleukin-6 (IL)-6), interleukin-8 (IL-8), and interleukin-12 (IL-12) were measured in both groups. IL-16, tumor necrosis factor (TNF)-伪, IgA,IgM,IgG, complement C3 and C4 and T cell subsets CD3~, CD4~, CD8~ and CD4~ / CD8~ were improved (P0.05). However, the improvement of the above indexes in the tacrolimus group was significantly better than that in the cyclophosphamide group (P0.05). Conclusion Tacrolimus combined with immunoadsorption has a good clinical effect on lupus nephritis in the elderly, and can significantly improve the inflammatory response and immune function of the body.
【作者单位】： 右江民族医学院附属医院肾内科;
【分类号】：R593.242
，
本文编号：2432377
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