摘要
目的:探讨贝利尤单抗治疗系统性红斑狼疮(SLE)的临床应用效果及对患者外周血分化簇40(CD40)和CD40配体(CD40L)表达的影响,为SLE的有效治疗提供理论依据。方法:回顾性分析本院收治的150例SLE患者的临床资料,按治疗方法将患者分为常规治疗组(接受标准治疗方案,78例)和贝利尤单抗组(在标准治疗方案基础上加用贝利尤单抗,72例)。比较2组患者疗效及不良反应,并分析2组患者治疗前后临床症状、器官受累情况、疾病活动度、泼尼松用量、外周血单核细胞中CD40和CD40L mRNA表达水平及免疫学相关指标水平。结果:与常规治疗组比较,贝利尤单抗组患者治疗后总有效率和补体C3及补体C4水平均明显升高(P<0.01或P<0.001),肾脏受累比例、SLE疾病活动指数-2K(SLEDAI-2K)评分、泼尼松用量、免疫球蛋白G(IgG)水平及外周血单核细胞中CD40和CD40L mRNA表达水平均明显降低(P<0.01或P<0.001)。2组患者治疗期间不良反应总发生率比较差异无统计学意义(P>0.05)。结论:贝利尤单抗可提高SLE治疗有效率,降低疾病活动度,减少肾脏受累和激素用量,且安全性良好,其作用机制可能与下调外周血中CD40和CD40L表达及改善免疫功能有关。
Objective:To explore the clinical application effect of belimumab in the treatment of systemic lupus erythematosus(SLE)and its influence on cluster of differentiation(CD40)and cluster of differentiation 40 ligands(CD40L)expression in the peripheral blood,and to provide a theoretical basis for the effective treatment of SLE.Methods:A retrospective analysis was conducted on the clinical data of 150 patients with SLE admitted to our hospital,and they were divided into conventional treatment group(n=78,standard treatment plan)and belimumab group(n=72,standard treatment plan+belimumab)according to the treatment methods.The therapeutic effects and adverse reactions were compared.The clinical symptoms,organ involvement,disease activities,prednisone doses,the expression levels of CD40 and CD40L mRNA in peripheral blood mononuclear cells,and the levels of immunology-related indicators before and after treatment were analyzed.Results:Compared with conventional treatment group,the total effective rate,complement C3 and complement C4 levels in the belimumab group were significantly increased after treatment(P<0.01 or P<0.001),while the proportion of renal involvement,the SLE disease activity index-2K(SLEDAI-2K)score,the dosage of prednisone,immunoglobulin G(IgG)level and the expression levels of CD40 and CD40L mRNA in peripheral blood mononuclear cells were decreased(P<0.01 or P<0.001).There was no statistically significant difference in the total incidence of adverse reactions between two groups during treatment period(P>0.05).Conclusion:Belimumab can increase the effective rate of SLE treatment,reduce disease activity,decrease the involvement of the kidneys and the dose of hormones,and has good safety;its mechanism of action may be related to down-regulating the expression of CD40 and CD40L in peripheral blood and improving the immune function.
作者
冯静
饶莉
史佳莉
孙静
解海茹
FENG Jing;RAO Li;SHI Jiali;SUN Jing;XIE Hairu(Second Department of Rheumatology and Immunology,Tangshan Workers’Hospital,Tangshan 063000,China;Department of Laboratory,Tangshan Workers’Hospital,Tangshan 063000,China)
出处
《吉林大学学报(医学版)》
北大核心
2025年第6期1679-1686,共8页
Journal of Jilin University:Medicine Edition
基金
河北省卫健委医学科学研究课题计划项目(20241672)。
关键词
系统性红斑狼疮
贝利尤单抗
泼尼松
分化簇40
分化簇40配体
Systemic lupus erythematosus
Belimumab
Prednisone
Cluster of differentiation 40
Cluster of Differentiation 40 ligands
