目的 分析泰它西普联合硫酸羟氯喹治疗系统性红斑狼疮的临床疗效。方法 选取2022年6月—2023年5月聊城市第二人民医院收治的102例系统性红斑狼疮患者，按随机数字表法将所有患者分为对照组和治疗组，每组各51例。对照组口服硫酸羟氯喹片，0.2 g/次，2次/d。治疗组在对照组治疗基础上腹部皮下注射注射用泰它西普，160 mg/次，以灭菌注射用水复溶，浓度为80 mg/mL，1次/周。两组疗程24周。观察两组临床疗效，比较两组治疗前后主症评分、系统性红斑狼疮疾病活动性指数2000（SLEDAI-2000）评分、一般实验室指标[红细胞沉降率（ESR）、24 h尿蛋白定量（24 h UP）、补体C3和C4、免疫球蛋白IgG]以及外周血自然杀伤细胞（NK细胞）表达和血清白细胞介素-6（IL-6）水平变化。结果 治疗后，治疗组总有效率是92.16%，显著高于对照组的76.47%（P＜0.05）。治疗后，两组面部红斑评分、气短评分、关节疼痛评分、疲乏评分、皮肤或肢端瘀紫评分和SLEDAI-2000评分均显著降低（P＜0.05）；治疗后，治疗组主症评分和SLEDAI-2000评分低于对照组（P＜0.05）。治疗后，两组ESR、血清CRP、24 h UP、IgG、IgM、IgA水平均显著降低，而血清补体C3、C4水平均显著升高（P＜0.05）；治疗后，两组一般实验室指标改善以治疗组更显著（P＜0.05）。治疗后，两组外周血NK细胞水平均显著上升，而血清IL-6水平均显著下降（P＜0.05）；治疗后，NK细胞和血清IL-6水平以治疗组改善更显著（P＜0.05）。结论 泰它西普联合硫酸羟氯喹治疗系统性红斑狼疮的效果确切，能缓解临床症状，抑制机体免疫功能异常和炎症反应，降低疾病活动度及肾功能损伤，值得临床推广应用。

Objective To investigate the therapeutic effect of telitacicept combined with hydroxychloroquine sulfate in treatment of systemic lupus erythematosus. Methods A total of 102 patients with systemic lupus erythematosus admitted to The Second People’s Hospital of Liaocheng from June 2022 to May 2023 were selected and divided into control group and treatment group according to random number table method, with 51 cases in each group. Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets, 0.2 g/time, twice daily. Patients in the treatment group received abdominal subcutaneous injection of Telitacicept for injection on the basis of the control group, 160 mg/time, redissolved with sterilized water for injection at a concentration of 80 mg/mL, once weekly. Both groups were treated for 24 weeks. The clinical efficacy of the two groups were observed, and main symptom score, SLEDAI-2000 score, general laboratory indicators [erythrocyte sedimentation rate (ESR), 24-hour urine protein quantification (24 h UP), complement C3 and C4, immunoglobulin IgG], as well as changes in peripheral blood natural killer cell (NK cell) expression and serum interleukin-6 (IL-6) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 92.16%, which was significantly higher than that of the control group (76.47%, P < 0.05). After treatment, the facial erythema score, shortness of breath score, joint pain score, fatigue score, skin or extremity bruise score and SLEDAI-2000 score were significantly decreased in both groups (P < 0.05). After treatment, the main disease score and SLEDAI-2000 score in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of ESR, serum CRP, 24 h UP, IgG, IgM and IgA were significantly decreased, while the levels of serum complement C3 and C4 were significantly increased in both groups (P < 0.05). After treatment, the general laboratory indexes of the two groups improved more significantly than that of the treatment group (P < 0.05). After treatment, the level of NK cells in peripheral blood was significantly increased, but the level of IL-6 in serum was significantly decreased in both groups (P < 0.05). After treatment, the levels of NK cells and serum IL-6 were significantly improved in the treatment group (P < 0.05). Conclusion Telitacicept combined with hydroxychloroquine sulfate has a definite effect in treatment of systemic lupus erythematosus, and can alleviate clinical symptoms, inhibit immune dysfunction and inflammatory response, reduce disease activity and renal function injury, which is worthy of clinical application.

R976

山东省医药卫生科技发展计划项目(202211000916)