静脉注射免疫球蛋白对重症系统性红斑狼疮的疗效及安全性

摘要

Objective To evaluate the efficacy and safety of intravenous immunoglobulin(IVIG)combined with corticosteroids and immunosuppressive agents in severe systemic lupus erythematosus(SLE).Methods A total of 60 severe SLE patients were enrolled in this study.The patients were randomly assigned to control group and IVIG group. All patients received standard therapy (corticosteroids combined with immunosuppressive agents,such as cyclophosphamide,mycophenolate mofetil or cyclosporin A).In addition to that,the patients in IVIG group received IVIG therapy (400 mg·kg-1 ·d-1 for five consecutive days).Outcome measures included SLE Disease Activity Index (SLEDAI),duration of hospitalization,hospital infection and adverse effect rate were observed.Results After treatment for 12 weeks,the patients in IVIG group had lower SLEDAI score than in control group,4.0(3.0,6.3)vs 5.5(4.0,8.5),Z =-2.420(P 0.05).No severe adverse effects were reported in either group.Conclusion IVIG combined with standard therapy showed good efficacy and safety in treatment for severe SLE patients.%目的：探讨静脉注射免疫球蛋白(IVIG)联合糖皮质激素、免疫抑制剂治疗重症系统性红斑狼疮(SLE)的疗效及安全性。方法采用前瞻性随机对照研究,重症 SLE 患者60例,随机分为对照组及 IVIG 组,两组患者均接受激素及免疫抑制剂治疗,IVIG 组同时接受 IVIG(400 mg·kg-1·d-1,连用5天)治疗。观察两组患者 SLE 疾病活动指数(SLEDAI)、平均住院日、院内感染率及不良反应发生率。结果治疗后12周,IVIG 组 SLEDAI 为4.0(3.0,6.3),对照组 SLEDAI 为5.5(4.0,8.5),两组比较差异具有统计学意义(Z =-2.420,P 0.05)；治疗过程中无严重不良反应发生。结论 IVIG 联合激素、免疫抑制剂治疗重症 SLE 具有良好的疗效及安全性。