环磷酰胺联合人免疫球蛋白治疗系统性红斑狼疮疗效及其对患者血清MCP―4和IL―4影响.docVIP

环磷酰胺联合人免疫球蛋白治疗系统性红斑狼疮疗效及其对患者血清MCP―4和IL―4影响 　　【摘要】 目的 探析系统性红斑狼疮采用环磷酰胺与人免疫球蛋白联合治疗对患者血清单核细胞趋化蛋白4（MCP-4）及白细胞介素-4（IL-4）的影响效果。方法 78例系统性红斑狼疮患者为研究对象， 根据电脑随机法将其分为对照组和观察组， 各39例。对照组给予常规治疗， 观察组则运用环磷酰胺与人免疫球蛋白联合治疗， 比较两组治疗效果。结果 治疗前， 两组的IL-4和MCP-4水平比较， 差异无统计学意义（P0.05）。连续治疗4周后， 观察组的治疗总有效率为94.88%， 高于对照组的74.36%， 差异有统计学意义（P0.05）。观察组的血清IL-4和MCP-4、24 h尿蛋白水平与系统性红斑狼疮疾病活动指数（SLEDAI）评分均低于对照组， 差异有统计学意义（P0.05）。结论 临床上给予系统性红斑狼疮患者人免疫球蛋白与环磷酰胺联合治疗， 可以使血清MCP-4和IL-4水平降低， 使Th1和Th2细胞免疫平衡恢复， 有助于提高治疗效果。 　　【关键词】 系统性红斑狼疮；人免疫球蛋白；环磷酰胺；单核细胞趋化蛋白4；白细胞介素-4 　　DOI：10.14163/j.cnki.11-5547/r.2017.13.043 　　【Abstract】 Objective To explore and analyze the effect of cyclophosphamide combined with human immunoglobulin in the treatment of systemic lupus erythematosus and its impact on serum monocyte chemoattractant protein 4 （MCP-4） and interleukin-4 （IL-4） in patients. Methods A total of 78 systemic lupus erythematosus patients as study subjects were divided by computer random method into control group and observation group， with 39 cases in each group. The control group received conventional therapy， and the observation group received combined therapy of cyclophosphamide and human immunoglobulin. Therapeutic effect was compared in two groups. Results Before treatment， both groups had no statistically significant difference in IL-4 and MCP-4 level （P0.05）. After 4 weeks of treatment， the observation group had higher total treatment effective rate as 94.88% than 74.36% in the control group， and the difference had statistical significance （P0.05）. The observation group had lower serum IL-4， MCP-4， 24 h urinary protein level and systemic lupus erythematosus disease activity index （SLEDAI） score than the control group， and the difference had statistical significance （P0.05）. Conclusion Combination of cyclophosphamide and human immunoglobulin can reduce MCP-4 and IL-4 level of systemic lupus erythematosus patients， recover Th1 and Th2 cellular immune balance and help to improve therapeutic effect. 　　【Key words】 Systemic