摘要
目的探讨活动性狼疮性肾炎(lupus nephritis,LN)治疗中选择泰它西普联合标准方案的价值。方法选取2021年3月—2024年3月三明市第一医院收治的50例活动性LN患者为研究对象,按照随机数字表法以1∶1比例分为对照组与观察组,每组25例,对照组实施标准方案治疗,观察组在对照组基础上给予泰它西普治疗。比较2组的临床疗效、免疫功能指标水平、肾功能指标水平及不良反应发生率。结果治疗后,观察组的总有效率(96.00%)稍高于对照组(88.00%),但比较差异无统计学意义(P>0.05)。观察组的CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)、补体C3、补体C4水平分别为(34.28±5.14)%、(41.13±3.12)%、(1.42±0.21)、(0.97±0.24)g/L、(0.18±0.07)g/L,高于对照组的(29.64±4.14)%、(36.14±4.11)%、(1.23±0.24)、(0.77±0.28)g/L、(0.14±0.05)g/L,免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白M(immunoglobulin M,IgM)水平分别为(10.91±2.42)g/L、(1.61±0.42)g/L、(0.69±0.11)g/L,低于对照组的(14.72±1.99)g/L、(2.21±0.61)g/L、(0.82±0.12)g/L,差异均有统计学意义(P<0.05)。观察组的血肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)、24 h尿蛋白定量、尿β_(2)-微球蛋白水平分别为(91.44±51.68)μmol/L、(7.34±2.14)mmol/L、(0.27±0.04)g、(104.66±27.62)μg/L,均低于对照组的(115.45±27.72)μmol/L、(8.54±1.26)mmol/L、(0.72±0.16)g、(141.82±29.72)μg/L,差异均有统计学意义(P<0.05)。2组不良反应的总发生率比较差异无统计学意义(P>0.05)。结论活动性狼疮性肾炎治疗中选择泰它西普联合标准方案可改善患者临床症状与肾功能,减轻疾病对免疫功能的影响,继而确保治疗有效性与安全性。
Objective To explore the value of selecting the combination of tacrolizumab standard regimen in the treatment of active lupus nephritis(LN).Methods Fifty patients with active LN admitted to Sanming First Hospital from March 2021 to March 2024 were selected as the research subjects.They were randomly divided into a control group and an observation group in a 1:1 ratio using a random number table method,with 25 patients in each group.The control group received standard regimen treatment,while the observation group received treatment with tacrolizumab in addition to the control group.The clinical efficacy,immune function index levels,renal function index levels,and incidence of adverse reactions between two groups were compared.Results After treatment,the total effective rate of the observation group(96.00%)was slightly higher than that of the control group(88.00%),but the difference was not statistically significant(P>0.05).In the observation group,the levels of CD8^(+),CD4^(+),CD4^(+)/CD8^(+),complement C3,and complement C4 were(34.28±5.14)%,(41.13±3.12)%,(1.42±0.21),(0.97±0.24)g/L,and(0.18±0.07)g/L,respectively,all of which were higher than those in the control group,which were(29.64±4.14)%,(36.14±4.11)%,(1.23±0.24),(0.77±0.28)g/L,and(0.14±0.05)g/L.The immunoglobulin G(IgG),immunoglobulin A(IgA),and immunoglobulin M(IgM)levels in the observation group were(10.91±2.42)g/L,(1.61±0.42)g/L,and(0.69±0.11)g/L,respectively,all lower than those in the control group,which were(14.72±1.99)g/L,(2.21±0.61)g/L,and(0.82±0.12)g/L.All differences were statistically significant(P<0.05).In the observation group,serum creatinine(Scr),blood urea nitrogen(BUN),24-hour urinary protein,and urinary β_(2)-microglobulin were(91.44±51.68)μmol/L,(7.34±2.14)mmol/L,(0.27±0.04)g,and(104.66±27.62)μg/L,respectively,all lower than those in the control group,which were(115.45±27.72)μmol/L,(8.54±1.26)mmol/L,(0.72±0.16)g,and(141.82±29.72)μg/L,the differences were statistically significant(P<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(P>0.05).Conclusion The use of the combination of tacrolizumab standard regimen in the treatment of active LN can improve patients'clinical symptoms and renal function,reduce the impact of the disease on immune function,and ensure the effectiveness and safety of treatment.
作者
刘有添
邓琼
LIU Youtian;DENG Qiong(Department of Rheumatology and Immunology,Sanming First Hospital,Sanming Fujian 365000,China)
出处
《中国卫生标准管理》
2025年第14期127-131,共5页
China Health Standard Management
关键词
泰它西普
标准方案
活动性病变
狼疮性肾炎
临床疗效
免疫功能
尿蛋白
tacrolizumab
standard regimen
active pathological change
lupus nephritis
clinical efficacy
immunity
urine protein
