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目的 回顾性研究 ,旨在探讨PMC治疗 (小剂量泼尼松合并甲氨蝶呤、氯喹 )对于轻、中度活动期SLE患者的疗效及副作用 ,以减少药物用量和副作用。方法 将入选的门诊患者按起始激素剂量 ,分为A (泼尼松剂量≤ 0 2mg·kg-1·d-1)和B (泼尼松 0 5～ 0 6mg·kg-1·d-1)两组 ,并联合应用甲氨蝶呤 7 5～ 10mg/周及氯喹 0 2 5g/d ,各 30例。观察疗效和副作用 ,为期 1年。结果 A组积分由治疗前的 2 1± 1 4降至 0 9± 0 7,B组感染多于A组 (2 2∶7,P <0 0 0 1) ,其中多为肺部感染 ,其次为皮肤感染。B组由 2 9± 2 3降至 1 3± 1 3。二组治疗前后相比疗效显著 ,但A、B两组间的疗效差异无显著性。B组中出现了库兴综合征及股骨头无菌性坏死 ,A组没有。结论 PMC方案对没有严重内脏累及的轻到中度的SLE患者有效。但在加大激素剂量的B组 ,感染问题比较突出
Objective To investigate the efficacy and side effects of PMC treatment (low-dose prednisone combined with methotrexate and chloroquine) on mild and moderate active SLE patients and to reduce the dosage and side effects. Methods The selected outpatients were divided into three groups according to the initial hormonal dose: A (prednisone dose ≤ 0 2 mg · kg-1 · d-1) and B (prednisone 0 5 ~ 0 6 mg · kg-1 · d- 1) two groups, combined with methotrexate 75 ~ 10mg / week and chloroquine 025g / d, each 30 cases. Observation of efficacy and side effects for a period of 1 year. Results The scores of group A were decreased from 21 ± 14 to 0 9 ± 0 7 before treatment, while that of group B was more than that of group A (2: 7, P <0 001), most of them were pulmonary infection, and secondly Infected for the skin. Group B decreased from 29 ± 23 to 1 3 ± 1 3. Two groups before and after treatment compared to significant effect, but A, B between the two groups showed no significant difference between the efficacy. In group B, Cushing’s syndrome and aseptic necrosis of femoral head appeared, while group A did not. Conclusion The PMC regimen is effective in patients with mild to moderate SLE without severe visceral involvement. However, in the group B with increasing hormonal dose, the problem of infection is prominent