目的 分析泰它西普聯(lián)合硫酸羥氯喹治療系統(tǒng)性紅斑狼瘡的臨床療效。方法 選取2022年6月—2023年5月聊城市第二人民醫(yī)院收治的102例系統(tǒng)性紅斑狼瘡患者，按隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各51例。對照組口服硫酸羥氯喹片，0.2 g/次，2次/d。治療組在對照組治療基礎(chǔ)上腹部皮下注射注射用泰它西普，160 mg/次，以滅菌注射用水復(fù)溶，濃度為80 mg/mL，1次/周。兩組療程24周。觀察兩組臨床療效，比較兩組治療前后主癥評分、系統(tǒng)性紅斑狼瘡疾病活動性指數(shù)2000（SLEDAI-2000）評分、一般實(shí)驗(yàn)室指標(biāo)[紅細(xì)胞沉降率（ESR）、24 h尿蛋白定量（24 h UP）、補(bǔ)體C3和C4、免疫球蛋白IgG]以及外周血自然殺傷細(xì)胞（NK細(xì)胞）表達(dá)和血清白細(xì)胞介素-6（IL-6）水平變化。結(jié)果 治療后，治療組總有效率是92.16%，顯著高于對照組的76.47%（P＜0.05）。治療后，兩組面部紅斑評分、氣短評分、關(guān)節(jié)疼痛評分、疲乏評分、皮膚或肢端瘀紫評分和SLEDAI-2000評分均顯著降低（P＜0.05）；治療后，治療組主癥評分和SLEDAI-2000評分低于對照組（P＜0.05）。治療后，兩組ESR、血清CRP、24 h UP、IgG、IgM、IgA水平均顯著降低，而血清補(bǔ)體C3、C4水平均顯著升高（P＜0.05）；治療后，兩組一般實(shí)驗(yàn)室指標(biāo)改善以治療組更顯著（P＜0.05）。治療后，兩組外周血NK細(xì)胞水平均顯著上升，而血清IL-6水平均顯著下降（P＜0.05）；治療后，NK細(xì)胞和血清IL-6水平以治療組改善更顯著（P＜0.05）。結(jié)論 泰它西普聯(lián)合硫酸羥氯喹治療系統(tǒng)性紅斑狼瘡的效果確切，能緩解臨床癥狀，抑制機(jī)體免疫功能異常和炎癥反應(yīng)，降低疾病活動度及腎功能損傷，值得臨床推廣應(yīng)用。

Objective To investigate the therapeutic effect of telitacicept combined with hydroxychloroquine sulfate in treatment of systemic lupus erythematosus. Methods A total of 102 patients with systemic lupus erythematosus admitted to The Second People’s Hospital of Liaocheng from June 2022 to May 2023 were selected and divided into control group and treatment group according to random number table method, with 51 cases in each group. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets, 0.2 g/time, twice daily. Patients in the treatment group received abdominal subcutaneous injection of Telitacicept for injection on the basis of the control group, 160 mg/time, redissolved with sterilized water for injection at a concentration of 80 mg/mL, once weekly. Both groups were treated for 24 weeks. The clinical efficacy of the two groups were observed, and main symptom score, SLEDAI-2000 score, general laboratory indicators [erythrocyte sedimentation rate (ESR), 24-hour urine protein quantification (24 h UP), complement C3 and C4, immunoglobulin IgG], as well as changes in peripheral blood natural killer cell (NK cell) expression and serum interleukin-6 (IL-6) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 92.16%, which was significantly higher than that of the control group (76.47%, P < 0.05). After treatment, the facial erythema score, shortness of breath score, joint pain score, fatigue score, skin or extremity bruise score and SLEDAI-2000 score were significantly decreased in both groups (P < 0.05). After treatment, the main disease score and SLEDAI-2000 score in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of ESR, serum CRP, 24 h UP, IgG, IgM and IgA were significantly decreased, while the levels of serum complement C3 and C4 were significantly increased in both groups (P < 0.05). After treatment, the general laboratory indexes of the two groups improved more significantly than that of the treatment group (P < 0.05). After treatment, the level of NK cells in peripheral blood was significantly increased, but the level of IL-6 in serum was significantly decreased in both groups (P < 0.05). After treatment, the levels of NK cells and serum IL-6 were significantly improved in the treatment group (P < 0.05). Conclusion Telitacicept combined with hydroxychloroquine sulfate has a definite effect in treatment of systemic lupus erythematosus, and can alleviate clinical symptoms, inhibit immune dysfunction and inflammatory response, reduce disease activity and renal function injury, which is worthy of clinical application.

R976

山東省醫(yī)藥衛(wèi)生科技發(fā)展計(jì)劃項(xiàng)目(202211000916)