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环磷酰胺联合来氟米特序贯治疗中重度系统性红斑狼疮的疗效与安全性分析

  

  1. 河北省人民医院 风湿免疫科, 河北 石家庄 050051
  • 出版日期:2017-10-05 发布日期:2017-10-10
  • 通讯作者: 通信作者:张风肖,Email:zfx8889@163.com
  • 基金资助:
    河北省科技厅科技支撑计划项目(13277760D)

Efficacy and safety of leflunomide and cyclophosphamide in  sequential therapy of systemic lupus erythematosus

  1. Department of Rheumatology,  Hebei General Hospital,  Shijiazhuang  050051,  China
  • Online:2017-10-05 Published:2017-10-10
  • Contact: Corresponding author: Zhang Fengxiao, Email:zfx8889@163.com

摘要: 目的 探讨环磷酰胺(CYC)联合来氟米特(LEF)序贯治疗中重度系统性红斑狼疮(SLE)的疗效及安全性。方法 选取新发初治的中重度活动期SLE患者45例,随机分为2组, 治疗组(24例)使用激素和CYC(静脉0.6 g/2周)12周后继续应用LEF口服20 mg/d序贯治疗, 对照组(21例)单纯以激素和CYC(静脉0.6 g/2周)治疗。观察两组患者SLE疾病活动指数(SLEDAI)、补体、肝肾功能及不良反应发生率。 结果 治疗24周后,两组SLEDAI均有下降,补体均提高。治疗组不良反应主要是感染,以带状疱疹多见,无月经不调。结论 CYC联合LEF序贯治疗中重度活动期系统性红斑狼疮疗效显著。

关键词: 红斑狼疮, 系统性;来氟米特; 环磷酰胺;序贯

Abstract: Objective  To evaluate the efficacy and safety of sequential therapy with leflunomide(LEF) and cyclophosphamide(CYC) in systemic lupus erythematosus(SLE). Methods  Totally 45 patients with SLE were recruited and randomly divided into two groups treatment group and control group. Patients of recent onset who had not used any immunosuppressive drugs were given either  Ⅳ  cyclophosphamide for 12  weeks (intravenously 0.6 g for two weeks), then were administrated with oral LEF for 12 weeks(20 mg/d) (treatment group) or  Ⅳ  cyclophosphamide (intravenously 0.6 g for two weeks)(control group) for 24 weeks. SLE disease activity index (SLEDAI), clinical and immunological tests were performed in the patients. The efficacy and safety of the drugs were evaluated at 24 weeks after treatment. Results  SLEDAI improved similarly in both groups after 24 weeks of treatment. Major adverse events  in both groups were infection and alopecia. Conclusion  CYC combined with  LEF  was more effective and safe in the induction therapy of SLE especially in reproductive aging female patients.

Key words: lupus erythematosus, systemic;leflunomide; cyclophosphamide; sequential