DNA免疫吸附治疗儿童重症狼疮近期疗效及安全性分析  

The effect and safety of immunoadsorption therapy for children with severe systemic lupus erythematosus

作　　者：刘颖[1] 吴玉斌[1] 

机构地区：[1]中国医科大学附属盛京医院小儿肾脏内科,沈阳110004

出　　处：《中国实用儿科杂志》2008年第10期760-763,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨DNA免疫吸附治疗儿童重症狼疮的近期临床疗效和安全性。方法2007年4月至2008年7月中国医科大学附属盛京医院小儿肾脏内科对9例重症狼疮患儿采用血液灌流DNA免疫吸附柱对每例进行3次吸附。观察其临床表现、对ANA、ds-DNA等自身抗体的清除效果,对免疫球蛋白、血清补体、24h尿蛋白定量、血常规、肝、肾功能、心肌酶谱、血清离子、血沉的影响。结果DNA免疫吸附后患儿的症状和体征均明显改善;ANA抗体滴度吸附后明显下降[(2515.56±1772.62)及(477.89±272.31),P<0.001];抗ds-DNA抗体被完全清除,其它自身抗体也被清除;免疫球蛋白IgG吸附后下降明显[(14.47±5.07)g/L及(8.53±1.30]g/L,P<0.001];血清补体有上升趋势,24h尿蛋白有下降趋势;对肝、肾功能、心肌酶谱、血清离子、血沉无明显影响,有4例血小板下降。结论DNA免疫吸附疗法能够在短时间内清除重症狼疮患儿体内抗ds-DNA和ANA抗体等免疫物质,使患儿度过免疫风暴导致的危重期,且具有较好的安全性。Objective To evaluate the treatment of DNA immunoadsorption （ IA） in the children with severe systemic lupus erythematosus （ SLE）. Methods Nine children with severe SLE were selected and treated with DNA immunoadsorption for three times and observed the changes of clinical symptoms, ANA, ds-DNA, complement, immunoglobulin, the a- mount of urine protein, blood rutine test, liver and kidney function, cardiac enzymes, electrolyte and ESR. Results The symptoms and signs were ameliorated after IA. The amount of ds-DNA was completely disappeared. The amount of ANA was decreased significantly （ before IA 2515.56± 1772. 62, after IA 477.89 ± 272. 31 P 〈 0. 001 ）. The amount of IgG was decreased significantly （ before IA 14.47 ± 5.07g/l, after IA 8.53 ±1.30g/1 P 〈 0. 001 ）. The complement was increased and the amount of urine protein was decreased. There was no effect on liver and kidney function, electrolyte, cardiac enzymes, and ESR. There were four cases with decreased thrombocytes. Conclusion DNA immunoadsorption（IA） can make ds-DNA and ANA decreased significantly in the children with severe SLE within short time and make the patients remission. It shows safety in children.

关 键 词：系统性红斑狼疮 血液净化 DNA免疫吸附 儿童 

分 类 号：R72[医药卫生—儿科]