目的 評價小劑量甲潑尼龍聯(lián)合甲氨蝶呤和羥氯喹治療輕中度系統(tǒng)性紅斑狼瘡（SLE）患者的療效及安全性。方法 96例輕到中度系統(tǒng)性紅斑狼瘡患者，按患者就診時間分為觀察組和對照組，各48例。兩組患者均給予甲氨蝶呤和羥氯喹；對照組加用雙氯芬酸鈉（75 mg/次，2次/d），觀察組加用甲潑尼龍（4 mg/次，2次/d），兩組均治療12周。比較兩組患者的療效和不良反應(yīng)發(fā)生情況。結(jié)果 兩組患者經(jīng)過12周的治療，觀察組有效率為91.67%，明顯高于對照組的64.58%，差異有統(tǒng)計學(xué)意義（P<0.05）。治療前，兩組患者間狼瘡疾病活動指數(shù)（SLEDAI）、紅細(xì)胞沉降率（ESR）、C反應(yīng)蛋白（CRP）、補(bǔ)體C3水平相比，差異均無統(tǒng)計學(xué)意義；治療后，兩組患者的SLEDAI積分、ESR、CRP、補(bǔ)體C3水平均較治療前明顯改善，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且觀察組比對照組改善更明顯，兩組間各指標(biāo)相比差異均具有統(tǒng)計學(xué)意義（P<0.05）。治療后兩組相比，觀察組的不良反應(yīng)發(fā)生率低，差異均有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 小劑量甲潑尼龍聯(lián)合甲氨蝶呤和羥氯喹治療系統(tǒng)性紅斑狼瘡療效顯著，安全性高，值得推廣。

Objective To investigate the clinical effect and safety of low-dose methylprednisolone combined with methotrexate and hydroxychloroquine in treatment of systemic lupus erythematosus (SLE). Methods 96 patients with mild-to-moderate systemic lumus erythematosus in our hospital from April 2012 to April 2017 were divide into control group and observation group according to visitiving time, 48 cases in each group. All the patients were given hydroxychloroquine and methotrexate therapy, while the control group was given meloxicam (7.5 mg/time, 2 times/d) in addition, and the observation group was given methylprednisolone (4 mg/time, 2 times/d) in addition. The clinical efficacy and adverse events were compared after the treatment. Results The score of SLEDAI, CRP, ESR, levels of C3 after the treatment were significantly better as compared with that before treatment in both groups (P<0.05). And the efficiency and incidence of adverse reactions of the observation groups were significantly better than the control group (P<0.05). Conclusion Low-dose methylprednisolone combined with methotrexate and hydroxychloroquine on treating systemic lupus erythematosus was safe, effective and worth to be prometed in clinical.