CAJ | 학술논문

目的：探讨糖皮质激素联合静注免疫球蛋白（IVIG）治疗系统性红斑狼疮（SLE）合并血小板减少的疗效及安全性。方法30例合并中重度血小板减少的SLE患者，随机分为实验组和对照组，每组15例。两组患者均接受糖皮质激素治疗；实验组联合应用静注免疫球蛋白（400mg/Kg/day，连用3天）。观察两组患者血小板计数变化、血小板恢复正常（100×109/L）的时间（天）、2周完全缓解率、平均住院日等。结果（1）治疗第4、7、10、14天实验组平均血小板计数高于对照组，差异具有统计学意义；（2）实验组血小板计数恢复正常的时间较对照组缩短（9.7±4.2天 vs 13.5±5.3天，P＜0.05）；实验组2周完全缓解率显著高于对照组（93.3% vs 46.7%, P＜0.05）；（3）对照组患者的平均住院日为16.1±4.4天，实验组平均住院日为12.7±3.7天，两组比较差异具有统计学意义（P＜0.05）。（4）治疗过程中无严重不良反应发生。结论糖皮质激素联合静注免疫球蛋白治疗狼疮合并中重度血小板减少具有较好的疗效及安全性。
목적：탐토당피질격소연합정주면역구단백（IVIG）치료계통성홍반랑창（SLE）합병혈소판감소적료효급안전성。방법30례합병중중도혈소판감소적SLE환자，수궤분위실험조화대조조，매조15례。량조환자균접수당피질격소치료；실험조연합응용정주면역구단백（400mg/Kg/day，련용3천）。관찰량조환자혈소판계수변화、혈소판회복정상（100×109/L）적시간（천）、2주완전완해솔、평균주원일등。결과（1）치료제4、7、10、14천실험조평균혈소판계수고우대조조，차이구유통계학의의；（2）실험조혈소판계수회복정상적시간교대조조축단（9.7±4.2천 vs 13.5±5.3천，P＜0.05）；실험조2주완전완해솔현저고우대조조（93.3% vs 46.7%, P＜0.05）；（3）대조조환자적평균주원일위16.1±4.4천，실험조평균주원일위12.7±3.7천，량조비교차이구유통계학의의（P＜0.05）。（4）치료과정중무엄중불량반응발생。결론당피질격소연합정주면역구단백치료랑창합병중중도혈소판감소구유교호적료효급안전성。
Objective To evaluate the efficacy and safety of corticosteroids combined with intravenous immunoglobulin (IVIG) in systemic lupus erythematosus (SLE) patients with thrombocytopenia. Method A total of 30 SLE patients with thrombocytopenia were enrolled in this study. The patients were randomly assigned to receive corticosteroids combined with IVIG (400mg/Kg/day for 3 consecutive days) or corticosteroids alone. Outcome measures included improvement in platelet counts, platelet recovery time, 2-week complete response (platelet count ≥100 × 109 /l) and duration of hospitalization. Result (1)In IVIG group, there were more rapid increases in platelet counts at 4, 7, 10, 14 days after treatment than control group. (2)Mean (±standard deviation, SD) platelet recovery time for IVIG group was shorter than that for control group (9.7±4.2days versus 13.5±5.3 days, P<0.05). 2 weeks after treatment, 93.3%of patients in IVIG group achieved complete responses, while 46.7%patients in control group achieved complete responses (P<0.05). (3)Patients in IVIG group had a shorter mean (±SD) hospitalization time compared with those in control group (12.7±3.7 days versus 16.1±4.4 days, P<0.05). (4)No severe adverse effects were reported in either group. Conclusion Corticosteroids combined with IVIG was effective and safe in treatment for SLE patients with thrombocytopenia.