羟氯喹致系统性红斑狼疮患者视网膜毒性的评价

Dandyala Pavan Kalyan, G. Teja, K. Reddy, Marina D’souza
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摘要

背景:系统性红斑狼疮(SLE)是一种影响人体主要器官的慢性自身免疫性疾病。SLE的病理生理机制尚不清楚。它主要影响关节,并限制他们的活动。抗疟疾药物羟氯喹(HCQ)被用作治疗SLE的第一线药物。该药的主要副作用是不可逆的视网膜病变。该研究的目的是评估长期使用羟氯喹(超过1年)的患者视网膜病变的发生率和患病率。方法:在SLE患者中,我们记录了长期服用HCQ(10 - 10年)的患者中HCQ引起的毒性。所有患者年龄均在18岁以上。共收集了210例SLE患者服用HCQ一年以上的数据。根据性别和剂量模式对患者进行分类。210例患者中,0例患者发现HCQ引起视网膜毒性。结果:采用合适的统计工具,对HCQ致毒的发生率和流行率进行数据分析。根据我们的研究结果,我们可以理解,发病率和患病率在受试者中非常低。结论:据说HCQ可以降低疾病缓解的风险,提高生存率,最大限度地降低重要器官损伤的风险,减少耀斑的频率,并对心血管健康具有保护作用。HCQ药物通常耐受性良好。但不可逆视网膜病变是长期使用HCQ的主要影响。目前的研究得出的结论是,在每日200mg的名义剂量下,在接受HCQ治疗的5年内,100%的人群没有显示任何视网膜毒性的迹象,这表明毒性是罕见的,可以通过减少药物剂量来预防。
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Evaluation of hydroxychloroquine induced retinal toxicity in systemic lupus erythematosus patients
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder, which affects the major organs in the human body. Pathophysiology of SLE is unknown. It mainly affects the joints, and restricts their movement. Hydroxychloroquine (HCQ) an anti-malarial drug is used as the first line of drugs used to treat SLE. The major adverse effect of this drug is irreversible retinopathy. The aim of the study was to evaluate the incidence and prevalence of retinopathy in patients with long-term usage of hydroxychloroquine (for more than 1 year).Methods: In patients with SLE, we recorded a review on HCQ induced toxicity among those taking it for longer period (>1 year). All the patients were above 18 years of age. A total data of 210 patients suffering from SLE and taking HCQ for more than one year was collected. Patients were categorized according to gender and dose pattern. Out of 210 patients, 0 patients were found to be retinal toxic induced by HCQ.Results: Suitable statistical tools were used and data was analysed which showed the incidence and prevalence of HCQ induced toxicity. With the results of our study we can understand that incidence and prevalence rates were very low among the subjects.Conclusions: HCQ is said to reduce the risk of disease remission, improves survival, minimizes the risks of vital organ damage, reduces the frequency of flares and has a protective effect on cardiovascular health.  HCQ medication is usually well tolerated.  But irreversible retinopathy is the major effect on long term use of HCQ.  The present study concludes that in the nominal daily dose of 200mg did not reveal any signs of retinal toxicity in 100% of the population tested within 5 years of HCQ treatment suggesting that the toxicity is rare and can be prevented by reducing the dose of the drug.
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