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