中国麻风皮肤病杂志 ›› 2019, Vol. 35 ›› Issue (6): 334-337.doi: 10.12144/zgmfskin201906334

• 论著 • 上一篇    下一篇

人免疫球蛋白联合醋酸泼尼松治疗系统性红斑狼疮的效果及对患者CD28、ICOS、Tim-1表达的影响

周静  黄闯  彭凤玲   

  1. 云南昆钢医院消化内科，云南安宁,650302
  • 出版日期:2019-06-15 发布日期:2019-06-06
  • 通讯作者: 周静，E-mail：pptzn63@163.com

Efficacy of human immunoglobulin combined with prednisone in the treatment of systemic lupus erythematosus and the impact on the level of CD28, ICOS and Tim-1

ZHOU Jing, HUANG Chuang, PENG Fengling   

  1. Department of Gastroenterology, Yunnan Kungang Hospital, Anning 650302, China
  • Online:2019-06-15 Published:2019-06-06
  • Contact: ZHOU Jing, E-mail: pptzn63@163.com

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摘要： 目的：评价人免疫球蛋白联合醋酸泼尼松治疗系统性红斑狼疮的效果及对患者CD28、可诱导共刺激因子（ICOS）、T细胞免疫球蛋白黏蛋白域蛋白-1（Tim-1）表达的影响。方法：选取2016年5月至2018年5月于我院接受治疗的系统性红斑狼疮患者，分为泼尼松组和泼尼松组联合人免疫球蛋白组。系统性红斑狼疮疾病活动指数（SLEDAI）评价患者病情，检测两组患者24 h尿蛋白、IL-37、IL-18、IFN-γ、CD28、ICOS、Tim-1水平。结果：共收集120例患者，两组各60例，联合治疗组患者的治疗总有效率为96.67%，显著高于泼尼松组的85%(P＜0.05)，联合治疗组患者不良反应发生率为1.67%，低于泼尼松组的11.67%(P＜0.05)。联合治疗组治疗后患者24h尿蛋白、SLEDAI评分、血清IL-37、IL-18、IFN-γ、CD28、ICOS、Tim-1表达水平均低于泼尼松组患者(均P＜0.05)。结论：较单用泼尼松，人免疫球蛋白联合醋酸泼尼松片治疗系统性红斑狼疮更有效，不良反应更少，CD28、ICOS、Tim-1水平下降更明显。

关键词: 人免疫球蛋白, 醋酸泼尼松片, 系统性红斑狼疮

Abstract: Objective: To assess the efficacy of human immunoglobulin combined with prednisone in the treatment of systemic lupus erythematosus (SLE) and the impact of the level of CD28,  induced co-stimulators (ICOS) and T cell immunoglobulin domain protein-1 (Tim-1). Methods: The inpatients with SLE  diagnosed in our hospital from May 2016 to May 2018 were divided into prednisone group and immunoglobulin combined with prednisone group. SLE disease activity index (SLEDAI) was used to evaluate the patients condition. 24-hour urinary protein level, IL-37, IL-18, IFN-γ, CD28, ICOS and Tim-1 expression levels were detected. Results: One hundred and twenty patients were analyzed (60 patients in each group). The effective rate and adverse reaction in the combined group was 96.67% and 1.67%, while in the prednisone group those were 85% and 11.67%, with significant differences (Ps<0.05). After treatment, the level of 24h urinary protein, SLEDAI score, IL-37, IL-18, IFN - γ, CD28, ICOS, and tim-1 in the combined group was lower than those in the prednisone group, with significant differences (Ps<0.05). Conclusion: Compared to prednisone alone, human immunoglobulin combined with prednisone was more effective, less adverse reaction and more significant  decrease in the level of  CD28, ICOS and Tim-1. 

Key words: human immunoglobulin, prednisone, systemic lupus erythematosus