CAJ | 학술논문

目的：通过对比沙利度胺与泼尼松联合环磷酰胺治疗系统性红斑狼疮的临床疗效，探讨沙利度胺治疗系统性红斑狼疮的治疗效果。方法选取风湿免疫科收治的系统性红斑狼疮患者56例，分为两组，其中对照组28例，予糖皮质激素联合环磷酰胺常规治疗；试验组28例，单予沙利度胺治疗。治疗结束后，对比治疗前后红斑狼疮患者皮疹情况、血常规、肾功能及免疫指标。结果（1）治疗后两组患者皮疹均得到消退，对比临床疗效，试验组明显优于对照组，且试验组患者的皮疹消失时间比对照组明显减少，差异具有统计学意义（P＜0．05）。（2）治疗后试验组白细胞、淋巴细胞、血小板计数及血红蛋白水平均较对照组明显提高，差异有统计学意义（P＜0．05）。（3）治疗后两组患者肾脏功能均改善，且试验组尿蛋白较对照组下降，血浆清蛋白试验组较对照组明显上升，差异有统计学意义（P＜0．05）。（4）治疗后，试验组较对照组 ANA滴度及抗ds‐DNA 抗体下降明显，比较差异有统计学意义（P＜0．05）。结论沙利度胺能够明显改善系统性红斑狼疮皮疹病情，修复肾脏损伤，纠正贫血等血液疾病，通过有效清除免疫反应细胞来修复自身免疫耐受，治疗效果显著，值得临床推广。
목적：통과대비사리도알여발니송연합배린선알치료계통성홍반랑창적림상료효，탐토사리도알치료계통성홍반랑창적치료효과。방법선취풍습면역과수치적계통성홍반랑창환자56례，분위량조，기중대조조28례，여당피질격소연합배린선알상규치료；시험조28례，단여사리도알치료。치료결속후，대비치료전후홍반랑창환자피진정황、혈상규、신공능급면역지표。결과（1）치료후량조환자피진균득도소퇴，대비림상료효，시험조명현우우대조조，차시험조환자적피진소실시간비대조조명현감소，차이구유통계학의의（P＜0．05）。（2）치료후시험조백세포、림파세포、혈소판계수급혈홍단백수평균교대조조명현제고，차이유통계학의의（P＜0．05）。（3）치료후량조환자신장공능균개선，차시험조뇨단백교대조조하강，혈장청단백시험조교대조조명현상승，차이유통계학의의（P＜0．05）。（4）치료후，시험조교대조조 ANA적도급항ds‐DNA 항체하강명현，비교차이유통계학의의（P＜0．05）。결론사리도알능구명현개선계통성홍반랑창피진병정，수복신장손상，규정빈혈등혈액질병，통과유효청제면역반응세포래수복자신면역내수，치료효과현저，치득림상추엄。
Objective To investigate the efficacy of thalidomide in treating systemic lupus erythematosus (SLE) by comparing the clinical effects between thalidomide and prednisone combined with cyclophosphamide for treating SLE .Methods 56 patients with SLE in the rheumatism and immunology department of our hospital were se‐lected and randomly divided into two groups .28 cases in the control group were treated with the conventional therapy of glucocorticoid combined with cyclophosphamide ,while 28 cases in the experimental group were given only the tha‐lidomide treatment .After treatment ,the skin rash situation ,blood routine ,renal function and immune indexes were compared between before and after treatment in the two groups .Results (1)After the treatment ,the skin rashes in the two groups were disappeared ,but the effect in the experimental group was significantly superior to the control group ,moreover the skin rash disappearance time in the experimental group was obviously decreased compared with the control group ,the differences were statistically significant(P<0 .05) .(2) The counts of white blood cell(WBC) , platelets and lymphocytes and hemoglobin level after treatment in the experimental group were significantly increased compared with the control group ,the differences were statistically significant(P<0 .05) .(3)The renal function after treatment in the two groups was improved ,moreover the urinary protein level in the experimental group was de‐creased compared with the control group and the serum albumin level was increased obviously ,the differences were statistically significant(P<0 .05) .(4) The titer of ANA and anti‐ds‐DNA antibody level after treatment in the ex‐perimental group were decreased significantly ,the differences were statistically significant(P<0 .05) .Conclusion Thalidomide can obviously improve the skin rash situation in SLE ,repairs the renal injury ,corrects anemia and other blood diseases ,repairs the autoimmune tolerance by effectively removing immunoreactive cells ,the treatment effect is remarkable ,which is worth the clinical promotion .