静脉滴注免疫球蛋白治疗狼疮性肾炎并发感染的临床观察  

Clinical Observation of Intravenous Immunoglobulin Infusion in Treatment of Severe Lupus Nephritis Complicated With Infection

作　　者：吴建平[1] 沈世忠[1] 杨忠民[1] 胡义阳[1] 黄华桑[1] 

机构地区：[1]福建省泉州市第一医院,泉州362000

出　　处：《内科急危重症杂志》2004年第3期122-123,共2页Journal of Critical Care In Internal Medicine

摘　　要：目的 :探讨采用静脉滴注免疫球蛋白 (IVIG)治疗狼疮性肾炎 (LN)并发感染的疗效及适应证。方法 :13例LN并发感染患者 ,采用IVIG 4 0 0mg/ (kg·d) ,连用 3～ 5d ,此后给予泼尼松 (pred) 1mg/ (kg·d) ,4周后 ,按系统性红斑狼疮活动指数比较治疗前后病情控制情况、2 4h尿蛋白、尿红细胞数、C3 、C4、抗ds DNA抗体、血小板数以及抗核抗体。结果 :IVIG治疗 4周后 ,13例肺部感染全部治愈 ,上述指标于治疗前、后均有显著或非常显著差异 (P <0 .0 5或P <0 .0 1) ,5 / 13例ANA转阴性。结论 :IVIG联合 pred治疗LN并发感染是一有效治疗措施 ,尤其对LN并发感染并有血小板明显减少、体质差 ,暂时无法使用大剂量甲泼尼龙及Objective: To evaluate the efficacy and indications of intravenous immunoglobulin (IVIG) in treatment of lupus nephritis (LN) complicated with infection. Methods:Thirteen patients with LN complicated with infection were treated with IVIG at a dosage of 400 mg/(kg·d) for 3 to 5 consecutive days and followed with prednison 1 mg/(kg·d). The status of disease control, 24 hour urinary protein, urinary red cell (Urbc), C_3, C_4, antinuclear antibody (ANA), anti-double-stranded DNA (anti-dsDNA), blood platelet (Plt) were compared by calculating systemic lupus erythematosus disease active index (SLEDAI) before and 4 weeks after treatment. Results: All patients with pneumonia were cured after 4 week. There was a significant differences in the above indexes before and after treatment (P<(0.05) or (0.01)). Conclusions: IVIG combined with prednision therapy is an effective therapeutic measure for LN with infection, especially in patients with LN complicating with infection, obviously thrombocytopenia, intolerate to high dose methyprednisolone and/or immunosuppressive agents temporarily.

关 键 词：狼疮性肾炎 免疫球蛋白 疗效 适应证 

分 类 号：R593.242[医药卫生—内科学]