静注丙种球蛋白治疗重症狼疮性肾炎  

Effects of intravenous immunoglobulin (iv-ISG) on serious lupus nephritis: efficacyand mechanism

作　　者：马济民[1] 单剑萍[1] 程威英[1] 冯菡芳[1] 薛文清[1] 侯积寿[1] 

机构地区：[1]上海第二医科大学附属新华医院肾内科

出　　处：《肾脏病与透析肾移植杂志》1995年第6期519-521,共3页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：静脉注射丙种球蛋白（ｉｖ－ＩｇＧ）冲击治疗３例重症狼疮性肾炎，近期疗效满意。不仅感染控制，体温正常，尿量增多，心包及胸腔积液吸收，肝、肾功能逆转，尿蛋白排出明显减少，而且ＡＶＡ和ｄｓＤＶＡ水平显著降低，提示患者的异常免疫反应得到控制和调节。ｉｖ－ＩｇＧ冲击疗法与糖皮质激素和其它免疫抑制剂配合使用，对重症狼疮性肾炎尤其是静注环磷酰胺（ｉｖ－ＣＴｘ）有相对禁忌证蓄，可取得较好效果。uring the exacerbation of lupus hep-hritis (LN) ,intense corticosteroid treatmentassociated with immunosupressive drugs(puls doses of cyclophosphamide) is indicat-ed. However ,even this treatment is , in somecases ,ineffective and mortality with nosoco-mial infection may develop due to severeleukopemia and immunosuppression. There-fore ,it’s mandatory to search for an alterna-tive therapeutic agent which is not only ableto decrease lupus activity and improve renalinvolvement . but also increase host defensemechanism- Preliminary results of the effi-cacy of intravenous human IgG in three pa-tients with serious lupus nephritis (LN)where reported. 3 patients with serious LNrecerived pulse doses of IgG (200～300 mg/kg . d-1) for 2￣ 3 consecutive days ;these 3day boli were repeated 3 times at 1 monthintervals. The results showed that in 3 pa-tients with serious LN received iv-IgG ascompared with pretreatment : there were : ①the infection was inhibited ; ②the tempera-ture returned to normal: ③the excretion ofurine increased: ④ pericardial, pleural andperitoneal effusion disappeared;⑤ hepa-tonephritic functions were recovered fromabnormality ;⑥ the excretion of proteinuriadecreased signficantly: ⑦ serum levels ofANA and dsDNA markedly decreased inwhich the results suggest that the pulsetherapy of iv-IgG may be used as an im-inunosuppressor and an immunomodulatorin rivo. In conclusion, pulse therapy of iv-IgG seems to be benefit to patients with se-rious LN,but a randotnized clinical trial toconfirm this preliminary report is needed.

关 键 词：狼疮性肾炎 丙种球蛋白 药物疗法 静脉注射 

分 类 号：R593.242[医药卫生—内科学]