小剂量激素联合甲氨蝶呤、羟氯喹治疗系统性红斑狼疮的临床观察

目的评价单独糖皮质激素及小剂量的糖皮质激素联合羟氯喹、MTX治疗方案对于轻度到中度活动性系统性红斑狼疮（SLE）患者的疗效及副作用。方法入选70例病人,随机分为A组（35例）,单独糖皮质激素（0.5~0.6 mg/kg.d）及B组（35例）小剂量的糖皮质激素（≤0.2 mg/kg.d）联合羟氯喹、MTX,观察记录两组患者疗效、药物不良反应,为期1年。结果两组均能明显改善患者临床症状及降低SLIDA评分,两组间差异无统计学意义,两组疗效相当。但A组较B组在激素减量过程中更易复发,两组间比较差异有统计学意义（P〈0.05）。且A组出现副作用较多,两组间差异有统计学意义（P〈0.05）。结论对于没有严重内脏累及的轻到中度SLE患者,0.2 mg/kg.d的强的松,联合羟氯喹和MTX,可有效控制病情的发展及反复,且比单纯激素组副作用更小,是值得推广的联合治疗方法。

The clinical study of treatment of mild and moderate systemic lupus erythematosus

Objective To evaluate the effect of prednisone（0.5~0.6 mg/kg·d） and small dose prednisone（≤0.2 mg/kg·d） combination of hydroxychloroquine and MTX for mild and moderate systemic lupus erythematosus（SLE）.Methods 70 patients were randomly divided into two groups（each n=35）.Group A： alone prednisone（0.5~0.6 mg/kg·d） and group B： small doses of prednisone（0.2 mg/kg·d） combined with hroxychloroquine 0.2 bid and MTX10mg/weeks,The therapeutic and side effect of the drugs were observed for a year.Results The treatment of two groups were successful.There was no significant difference of efficacy between the two groups（P0.05）.But there were more recurrence in group A than that in group B.There were more side-effects in group A than that in group B.Conclusion Lupus patients of no serious visceral involvement with mild and moderate activity can be controlled well with small prednisone combination of hydroxychloroquine and MTX.