Study on clinical efficacy of tacrolimus combined with rituximab in the treatment of systemic lupus erythematosus
Objective To explore the clinical efficacy of tacrolimus combined with rituximab in the treatment of systemic lupus erythematosus,and its influence on serological indexes and T lymphocyte subsets.Methods 62 patients with systemic lupus erythematosus were divided into a control group(31 cases)and an observation group(31 cases)according to random number table method.The control group was treated with oral tacrolimus alone,and the observation group was treated with oral tacrolimus and intravenous rituximab.Patients in both groups were compared in terms of serological indicators(serum immunoglobulin,serum monocyte chemotactic protein-1,serum complement C3,C4)and T lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)before and after treatment,clinical efficacy and occurrence of adverse reactions.Results After treatment,the observation group had serum immunoglobulin A of(2.06±0.38)g/L,immunoglobulin G of(12.84±2.43)g/L,immunoglobulin M of(1.40±0.30)g/L,and monocyte chemotactic protein-1 of(90.48±32.84)pg/ml,which were significantly lower than those before treatment(3.40±0.50)g/L,(20.35±4.26)g/L,(2.75±0.61)g/L,and(368.88±41.10)pg/ml and in the control group after treatment(2.55±0.44)g/L,(15.58±2.56)g/L,(1.90±0.33)g/L,and(166.38±30.65)pg/ml;the observation group had serum complement C3 of(0.64±0.10)g/L and complement C4 of(0.22±0.04)g/L,which were significantly higher than those before treatment(0.40±0.08)and(0.10±0.03)g/L and in the control group after treatment(0.50±0.11)and(0.13±0.04)g/L.The difference was significant(P<0.05).In the control group,the serum immunoglobulin A,immunoglobulin G,immunoglobulin M and monocyte chemotactic protein-1 were lower than those before treatment,and serum complement C3 and complement C4 were higher than those before treatment.The difference was significant(P<0.05).After treatment,CD4+of(43.88±6.58)%and CD4+/CD8+of(1.14±0.22)in the observation group were significantly higher than those before treatment(35.60±5.50)%and(0.86±0.15)and in the control group after treatment(39.33±6.24)%and(1.00±0.20).The difference was significant(P<0.05).CD4+and CD4+/CD8+in the control group after treatment were higher than those before treatment,and the difference was significant(P<0.05).The total effective rate of the observation group was 93.55%(29/31),which was significantly higher than the control group's 70.97%(22/31),and the difference was significant(χ2=5.415,P<0.05).The incidence of adverse reactions in the control group was 32.26%(10/31),which was significantly higher than the observation group's 9.68%(3/31),and the difference was significant(χ2=4.769,P<0.05).Conclusion Tacrolimus combined with rituximab treatment for systemic lupus erythematosus can effectively regulate T lymphocyte subsets,increase the expression levels of complement C3 and C4,reduce the expression levels of immunoglobulin and monocyte chemotactic protein-1,effectively inhibit the progression of the disease,improve the clinical treatment effect,and have high clinical safety.
Systemic lupus erythematosusTacrolimusRituximabClinical study
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