摘要
目的探讨环磷酰胺联合甲泼尼龙对狼疮性肾炎(lupus nephritis,LN)患者的临床治疗效果。方法选取2021年5月至2022年5月兴义市人民医院收治的60例LN患者作为研究对象,按照随机数字表法分为对照组与观察组,各30例。对照组给予羟氯喹联合甲泼尼龙治疗,观察组给予环磷酰胺联合甲泼尼龙治疗,比较两组临床疗效、免疫功能(IgA、IgM、补体C_(3)、补体C_(4))、肾功能[血沉(erythrocyte sedimentation rate,ESR)、血清肌酐(serum creatinine,SCr)、24 h尿蛋白定量]、疾病活动度[SLE活动指数评分系统(systemic lupus erythematosus sisease activity index,SLEDAI)]及不良反应发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组IgA、IgM水平均低于治疗前,补体C_(3)、补体C_(4)水平均高于治疗前,且观察组IgA、IgM水平均低于对照组,补体C_(3)、补体C_(4)水平均高于对照组,差异有统计学意义(P<0.05);治疗后,两组ESR、SCr及24 h尿蛋白定量水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组SLEDAI评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论环磷酰胺联合甲泼尼龙治疗LN疗效显著,可提高患者免疫功能,改善肾功能,促进患者康复,且安全性较高,值得临床推广应用。
Objective To explore the clinical therapeuti effect of cyclophosphamide combined with methylprednisolone on patients with lupus nephritis(LN).Methods 60 patients with LN admitted to Xingyi People's Hospital from May 2021 to May 2022 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group was treated with hydroxychloroquine combined with methylprednisolone,while the observation group was treated with cyclophosphamide combined with methylprednisolone,the clinical efficacy,immune function(IgA,IgM,complement C_(3),complement C_(4)),renal function(erythrocyte sedimentation rate[ESR],serum creatinine[SCr],24 h urine protein quantification),disease activity(systemic lupus erythematosus disease activity index[SLEDAI])and adverse reactions were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of IgA and IgM of the two groups were lower than those before treatment,and the levels of complement C_(3) and complement C_(4) were higher than those before treatment,the levels of IgA and IgM in the observation group were lower than those in the control group,and the levels of complement C_(3) and complement C_(4) were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of ESR,SCr and 24 h urine protein quantification of the two groups were lower than those before treatment,and the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the SLEDAI scores of the two groups were lower than those before treatment,and the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Cyclophosphamide combined with methylprednisolone has a significant therapeutic effect on LN patients,can improve immune function,improve renal function,promote patient recovery,and has high safety,which is worthy of clinical promotion and application.
作者
杨延婷
姜嫄
龙琴
YANG Yanting;JIANG Yuan;LONG Qin(Department of Nephrology,Xingyi People's Hospital,Xingyi,Guizhou,562400,China;Department of Medicine,Qianxinan Ethnic Vocational and Technical College,Xingyi,Guizhou,562400,China)
出处
《当代医学》
2025年第5期123-126,共4页
Contemporary Medicine
关键词
狼疮性肾炎
环磷酰胺
甲泼尼龙
免疫功能
肾功能
疾病活动度
Lupus nephritis
Cyclophosphamide
Methylprednisolone
Immune function
Renal function
Disease activity
