CAJ | 학술논문

目的探讨SLE患者服用2种不同剂量羟氯喹后血药浓度与狼疮疾病活动度等临床和实验室指标的相关性,并评估其安全性.方法选取40例诊断明确的SLE患者,按服用剂量分成2组,每组20例,A组服用羟氯喹0.4 g,每日1次,B组服用羟氯喹0.2 g,每日1次,每组患者服用羟氯喹时间均≥6个月,高效液相色谱法检测羟氯喹血药浓度;收集患者各项实验室指标,进行SLEDAI评分,分析羟氯喹血药浓度和疾病活动度的相关性.采用t检验和Pearson相关性分析统计学方法.结果 A组患者羟氯喹血药浓度为(402±190) ng/ml,B组患者羟氯喹血药浓度为(150±60) ng/ml,2组间血药浓度差异有统计学意义(t=7.471,P＜0.01);2组患者SLEDAI评分差异无统计学意义(t=-0.172,P＞0.05);A组患者血小板计数为(188±88)×109/L,B组血小板计数为(158±87)×109/L,A组患者血小板计数明显高于B组(t=4.375,P＜0.05);2组患者其他实验室指标差异均无统计学意义(P＞0.05);2组均未见不良反应.结论 SLE患者服用羟氯喹0.2 g,每日1次和0.4 g,每日1次比较,血药浓度有很大的分布区间,有较好的安全性.
목적 탐토SLE환자복용2충불동제량간록규후혈약농도여랑창질병활동도등림상화실험실지표적상관성,병평고기안전성.방법 선취40례진단명학적SLE환자,안복용제량분성2조,매조20례,A조복용간록규0.4 g,매일1차,B조복용간록규0.2 g,매일1차,매조환자복용간록규시간균≥6개월,고효액상색보법검측간록규혈약농도;수집환자각항실험실지표,진행SLEDAI평분,분석간록규혈약농도화질병활동도적상관성.채용t검험화Pearson상관성분석통계학방법.결과 A조환자간록규혈약농도위(402±190) ng/ml,B조환자간록규혈약농도위(150±60) ng/ml,2조간혈약농도차이유통계학의의(t=7.471,P＜0.01);2조환자SLEDAI평분차이무통계학의의(t=-0.172,P＞0.05);A조환자혈소판계수위(188±88)×109/L,B조혈소판계수위(158±87)×109/L,A조환자혈소판계수명현고우B조(t=4.375,P＜0.05);2조환자기타실험실지표차이균무통계학의의(P＞0.05);2조균미견불량반응.결론 SLE환자복용간록규0.2 g,매일1차화0.4 g,매일1차비교,혈약농도유흔대적분포구간,유교호적안전성.
Objective To study the blood concentration of hydroxychloroquine in patients with systemic lupus erythematosus (SLE) treated with different doses, and analyze the relationship between blood concentration of hydroxychloroquine and disease activity, and evaluate its safety.Methods Forty SLE patients were randomly divided into 2 groups, each group contained 20 cases.The patients in group A were treated with hydroxychloroquine (0.4 g, qd), while patients in group B were treated with hydroxychloroquine (0.2 g, qd).The treatment lasted more than six months in every patient.The blood concentrations of hydroxychloro-quine were detected by high performance liquid chromatography.The clinical and laboratory indices were collected.The systemic lupus erythematosus disease activity index (SLEDAI) score was recorded.The doses and varieties of combined hormone, immunosuppressant were recorded.The correlation of blood concentration of hydroxychloroquine and disease activity was analyzed.The significance was determined by Student's t test and Pearson correlation analysis.Results In SLE patients, the average blood concentration of hydro-xychloroquine was (402±190) ng/ml in group A and (150±60) ng/ml in group B (t=7.471, P＜0.01).The disease activities of patients in the two groups showed no significant difference (t=-0.172, P＞0.05).The platelet counts of patients in group A were significantly higher than those in group B[(188±88)×109/L vs (158 ±87) ×109/L] (t=4.375, P＜0.05).However, the other laboratory parameters showed no significant difference between the two groups (P＞0.05).Conclusion The results of this study indicate that the blood concentrations of hydroxy-chloroquine are significantly different in different dosages.The high dose of hydroxy-chloroquine is related to high platelet number in lupus patients.These findings suggest that hydroxychloroquine is safe and effective for SLE patients.