目的 研究羥氯喹聯(lián)合利妥昔單抗治療系統(tǒng)性紅斑狼瘡的臨床療效。方法 選擇2017年1月—2019年12月榆林市第二醫(yī)院的系統(tǒng)性紅斑狼瘡患者71例作為研究對(duì)象。用抽簽法隨機(jī)將患者分為對(duì)照組（36例）和觀察組（35例）。對(duì)照組iv利妥昔單抗注射液，100 mg/次，1次/周。觀察組在對(duì)照組基礎(chǔ)上口服硫酸羥氯喹片，0.4 g/次，2次/d。兩組均治療4周。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的系統(tǒng)性紅斑狼瘡疾病活動(dòng)指數(shù)（SLEDAI）評(píng)分、24 h尿蛋白、血肌酐、血清白蛋白和炎性因子水平。結(jié)果 治療后，觀察組的有效率為91.43%，明顯高于對(duì)照組的69.44（P<0.05）。治療后，兩組的SLEDAI評(píng)分、血肌酐及24 h尿蛋白水平明顯降低，血清白蛋白水平明顯升高（P<0.05）；且觀察組的SLEDAI評(píng)分、血肌酐及24 h尿蛋白水平明顯低于對(duì)照組，血清白蛋白水平明顯高于對(duì)照組（P<0.05）。治療后，兩組血清白細(xì)胞介素（IL）-4、IL-17和單核細(xì)胞趨化蛋白-4（MCP-4）水平明顯降低（P<0.05），且觀察組的血清IL-4、IL-17和MCP-4水平明顯低于對(duì)照組（P<0.05）。結(jié)論 羥氯喹聯(lián)合利妥昔單抗能改善系統(tǒng)性紅斑狼瘡患者的免疫功能，降低血清IL-4、IL-17和MCP-4水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To study the effect of hydroxychloroquine combined with rituximab on the patients with systemic lupus erythematosus. Methods A total of 71 patients with systemic lupus erythematosus in Yulin No. 2 Hospital from January 2017 to December 2019 were selected as study subjects. Patients were randomly divided into control group (36 cases) and observation group (35 cases) by lottery. Patients in the control group were iv administed with Rituximab Injection, 100 mg/time, once per week. Patients in the observation group po administered with Hydroxychloroquine Sulfate Tablets on the basis of control group, 0.4 g/time, twice daily. Both groups were treated for 4 weeks. After treatment, the clinical effects were observed, and SLEDAI score, the levels of 24 h urinary protein, serum creatinine and albumin, and inflammatory factors in two groups before and after treatment were compared. Results After treatment, the effective rate of the observation group was 91.43%, which was significantly higher than 69.44% of the control group (P<0.05). After treatment, SLEDAI score, serum creatinine and 24 h urinary protein levels were serum creatinine and 24 h urine protein levels in the observation group were significantly lower than those in the control group, but serum albumin levels were significantly higher than those in the control group (P<0.05). After treatment, serum levels of IL-4, IL-17 and MCP-4 in two groups were significantly decreased (P<0.05), and serum IL-4, IL-17 and MCP-4 levels in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Hydroxychloroquine combined with rituximab can improve the immune function of patients with systemic lupus erythematosus, and reduce the serum levels of IL-4, IL-17 and MCP-4, which has certain clinical application value.

R976

陜西省重點(diǎn)研發(fā)項(xiàng)目（2018SF-168）