抗CD20单克隆抗体在重症系统性红斑狼疮治疗中的临床价值

摘要

Objective:To investigate the the clinical curative effect of anti-CD20 monoclonal antibodies in the treatment of severe systemic lupus erythematosus (SLE).Methods: 66 patients with severe SLE were randomly divided into treatment group (36 cases) and control group (30 cases), all the patients were treated with anti CD20 monoclonal antibodies and immune inhibitors based on glucocorticoid pulse therapy. Compared the erythrocyte sedimentation rate(ESR), C reactive protein(CRP), mmunoglobulin (IgG, IgA, IgM), complement (C3, C4) , its antibody (ANA, ds-DNA) related indicators and the total efficiency between the two groups.Results: The number of B lymphocytes in peripheral blood at week 2 after treatment of the treatment group was lower than that of the control grou(t=13.167,P<0.05); ESR, CRP, immunoglobulin, ANA, ds-DNA, urinary protein and SLE disease activity index(SLEDAI) at week12 after treatment of the treatment group were lower than those of the control group, there was no significant difference in IgA, IgM and complement C4 compared with the control group(t=0.955,t=1.769,t=1.070;P>0.05), complement C3 level of the treatment group was higher than that of the control group, the total effective rate of the treatment group was higher than that of the control group(x2=5.390,P<0.05).Conclusion: CD20 monoclonal antibodies can improve the clinical efficacy in patients with severe SLE, it has an advantage of good safety.%目的：探讨抗CD20单克隆抗体治疗重症系统性红斑狼疮(SLE)的疗效，研究其临床治疗价值。方法：将66例重症SLE患者随机分为治疗组(36例)和对照组(30例)，在激素冲击疗法基础上，两组分别采用抗CD20单克隆抗体和免疫抑制剂治疗。比较治疗后两组的血沉(ESR）、C反应蛋白(CRP)、免疫球蛋白(IgG、IgA、IgM)、补体(C3、C4)及自身抗体(ANA、ds-DNA)相关指标和总有效率。结果：治疗后2周，治疗组外周血B淋巴细胞数量低于对照组(t=13.167，P＜0.05)；治疗后12周，治疗组ESR、CRP、免疫球蛋白、ANA、ds-DNA、尿蛋白定量及SLE疾病活动指数(SLEDAI)评分均低于对照组，IgA、IgM及补体C4与对照组相比，差异无统计学意义(t=0.955，t=1.769，t=1.070；P＞0.05)，补体C3水平高于对照组，治疗组总有效率高于对照组(x2=5.390，P＜0.05)。结论：CD20单克隆抗体可提高重症SLE患者的临床疗效，安全性好。