利妥昔单抗联合贝利尤单抗治疗难治性系统性红斑狼疮合并血栓性微血管病的疗效

doi:10.3969/j.issn.1671-7171.2025.10.028

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摘要【目的】探讨利妥昔单抗联合贝利尤单抗治疗难治性系统性红斑狼疮(SLE)合并血栓性微血管病(TMA)的疗效。【方法】80例难治性SLE合并TMA患者,随机分为利妥昔单抗治疗组(对照组,37例)和利妥昔单抗联合贝利尤单抗治疗组(联合组,43例),两组均治疗12周。比较两组疗效、治疗前后SLE疾病活动指数(SLEDAI)、血液学指标[白蛋白(ALB)、白细胞计数(WBC)、血小板计数(PLT)]、肾功能指标[血肌酐(SCr)、尿蛋白、尿红细胞]、免疫功能指标[补体成分3(C3)及补体成分4(C4)]、炎症标志物[红细胞沉降率(ESR)、高敏C反应蛋白(hs-CRP)]及不良反应发生情况。【结果】治疗后,联合组的治疗总有效率为93.02%,显著高于对照组的72.97%(P<0.05)。与治疗前比较,治疗后,两组患者各项临床指标较治疗前均有改善(P<0.05),且联合组患者SLEDAI、WBC、PLT、ALB、C3、ESR及hs-CRP较对照组明显改善(P<0.05);两组SCr、尿蛋白及尿红细胞计数比较,差异均无统计学意义(P>0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】利妥昔单抗联合贝利尤单抗治疗难治性SLE合并TMA患者,不仅能显著提高疗效,改善患者的肾功能,且安全性良好。

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	张丽娟
	韩立帅

关键词 ：红斑狼疮, 系统性, 血栓性微血管病, 利妥昔单抗

Abstract：【Objective】 To investigate the efficacy of rituximab combined with belimumab in the treatment of refractory systemic lupus erythematosus (SLE) complicated with thrombotic microangiopathy (TMA). 【Methods】 A total of 80 patients with refractory SLE and TMA were randomly divided into the rituximab monotherapy group (the control group, 37 cases) and the rituximab combined with belimumab group (the combination group, 43 cases). Both groups received treatment for 12 weeks. The therapeutic efficacy, changes in SLE Disease Activity Index (SLEDAI), hematological parameters [white blood cell count (WBC), platelet count (PLT)], renal function indicators [serum creatinine (SCr), urinary red blood cells], immune function markers [complement components 3(C3) and complement components 4(C4)], inflammatory markers [erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP)], and adverse reactions were compared between the two groups before and after treatment. 【Results】 After treatment, the total effective rate in the combination group was 93.02%, significantly higher than 72.97% in the control group (P<0.05). Compared with baseline, both groups showed improvement in all clinical parameters after treatment (P<0.05), with the combination group showing more significant improvements in SLEDAI, WBC, PLT, albumin levels, C3, ESR, and hs-CRP compared with the control group (P<0.05). No significant differences were observed between the two groups in urinary protein, SCr, and urinary red blood cell counts (P>0.05). The incidence of adverse reactions did not differ significantly between groups (P>0.05). 【Conclusion】 Rituximab combined with belimumab in patients with refractory SLE complicated with TMA significantly improves clinical efficacy, hematological and renal function parameters, while maintaining good safety.

Key words： Lupus Erythematosus, Systemic Thrombotic Microangiopathies Rituximab

收稿日期: 2025-04-10

中图分类号:

R593.241

通讯作者: * E-mail:hanlishuaimelody@163.com

引用本文:

张丽娟, 韩立帅. 利妥昔单抗联合贝利尤单抗治疗难治性系统性红斑狼疮合并血栓性微血管病的疗效[J]. 医学临床研究, 2025, 42(10): 1777-1780.
ZHANG Lijuan, HAN Lishuai. Efficacy of Rituximab Combined with Belimumab in the Treatment of Refractory Systemic Lupus Erythematosus Complicated with Thrombotic Microangiopathy. JOURNAL OF CLINICAL RESEARCH, 2025, 42(10): 1777-1780.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.10.028 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I10/1777

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