早期应用贝利尤单抗治疗儿童系统性红斑狼疮的临床意义

目的:探讨早期应用贝利尤单抗(BLM)治疗儿童系统性红斑狼疮(SLE)的价值。 方法:选取我院肾脏风湿免疫科 2020-2021 年住院确诊为 SLE 的患儿 23 例,分为三组:对照组(初诊未用 BLM)7 例、初发组(初诊即用 BLM)7 例、复发组(复发才用BLM)9 例,分析三组患儿使用 BLM 前后相关炎症指标、系统性红斑狼疮疾病活动度(SLEDAI)评分、激素用量等变化,比较三组患儿临床疗效。 结果:儿童 SLE 使用 BLM 后激素用量、SLEDAI 评分、血沉均降低(P 均<0. 01),且初发组临床缓解时间、激素用量、SLEDAI 评分均小于对照组(P 均<0. 05);复发组临床缓解时间长于初发组(P<0. 05);临床缓解时间与病程呈正相关(r =0. 606,P<0. 05)。 结论:BLM 治疗儿童 SLE 安全有效,可减少激素用量,降低疾病活动度,且早期应用更易缓解疾病。

Clinical Significance of Early Application of Belimumab in the Treatment of Systemic Lupus Erythematosus in Children

Objective: To probe into the value of early application of belimumab ( BLM) in the treatment of systemic lupus erythematosus (SLE) in children. Methods: A total of 23 children diagnosed with SLE admitted into the renal rheumatology department in our hospital from 2020 to 2021 were divided into three groups: control group (7 cases without BLM at initial diagnosis), initial onset group (7 cases with BLM at initial diagnosis), and recurrence group ( 9 cases with BLM only at recurrence). Changes of related inflammatory indicators, systemic lupus erythematosus disease activity index (SLEDAI) score and hormone dosage before and after BLM treatment in three groups were analyzed. Clinical efficacy of three groups were compared. Results: Hormone dosage, SLEDAI score and erythrocyte sedimentation rate decreased after BLM treatment in children with SLE (P<0. 01), and clinical remission time, hormone dosage and SLEDAI score in the initial onset group were lower than those in the control group ( P< 0. 05). The duration of clinical remission in relapse group was longer than that in initial onset group ( P < 0. 05). The duration of clinical remission was positively correlated with the course of disease (r = 0. 606, P<0. 05). Conclusion: BLM is safe and effective in the treatment of SLE in children, which can reduce hormone dosage and disease activity, and early application is more likely to achieve disease remission.