单中心免疫吸附治疗10年回顾性分析  

Retrospective analysis of immunoadsorption therapy in single-center for ten years

作　　者：姚国乾[1] 韩志武[1] 肖琼[1] 李靖[1] 徐友平[1] 沈俊[1] 

机构地区：[1]解放军第161医院全军血液净化中心,武汉430010

出　　处：《临床肾脏病杂志》2009年第5期207-210,共4页Journal Of Clinical Nephrology

摘　　要：目的评价免疫吸附疗法应用于自身免疫性疾病和高脂血症的效果及临床价值。方法回顾性分析我中心近10年来156例接受免疫吸附治疗的自身免疫性疾病及高脂血症患者的临床资料。所有患者均应用Citem10免疫吸附系统，使用了A蛋白、PH350、TR350、DNA、抗低密度脂蛋白胆固醇（LDL-C）抗体等5种不同吸附材料的吸附柱。监测自身免疫性疾病患者治疗前后免疫球蛋白、补体、自身抗体、血常规、肝功能、肾功能等指标，比较疾病活动评分以及器官损害指数；监测高脂血症患者治疗前后血脂水平。结果免疫吸附治疗后，自身免疫性疾病患者血浆IgG清除率为（76．71±7．59）％，治疗前后有统计学差异（P〈0．05），IgA清除率为（44．54±5．92）％，治疗前后有统计学差异（P〈0．05），IgM清除率为（45．76±5．65）％，治疗前后有统计学差异（P〈0．05），血抗核抗体、抗双链DNA、乙酰胆碱受体抗体、类风湿性关节炎相关抗体或标记物阳性率降低。与治疗前相比，高脂血症患者血浆LDL-C、甘油三酯浓度显著降低，差异有统计学意义（P〈0．05）。所有患者病情显著好转，器官受损情况明显改善。结论免疫吸附疗法可迅速有效的清除自身抗体和血脂成分，使病情得到控制，保护受损脏器功能，对各种自身免疫性疾病及高脂血症均具有良好治疗效果，在病情进展阶段抓住时机应用免疫吸附疗法，效果更显著。Objective To evaluate the application of immunoadsorption therapy for autoimmune diseases and the hyperlipidemia. Methods 156 cases of autoimmune disease and hyperlipidemia were collected over the past ten years in our treatment center. All cases were treated with immunoadsorp- tion therapy, applicationed by the Citem 10 immunosorbent assay system, using protein A, PH350, TR350, DNA, low-density lipoprotein-cholesterol antibodies immunoadsorption column material. In autoimmune disease cases, immune globulin, complement, autoantibodies, blood routine, liver and kidney function were observed before and after treatment, recorded the disease activity score and organ damage index. In hyperlipidemic cases, lipid levels were observed before and after treatment. Results After immunoadsorption treatment, plasma IgG, IgA and IgM clearance rate in the patients with autoimmune diseases was（76. 71 ± 7. 59）%（P〈0. 05）, （44. 54 ± 5.92）% （P〈0. 05） and（45.76 ± 5.65） （P〈0. 05） respectively. Plasma ANA, anti-dsDNA, acetylcholine receptor antibody,and rheumatoid arthritis associated factor were decreased. Plasma low-density lipoprotein-eholesterol and triglyceride in patients with hyperlipidemia were decreased significantly （P〈0. 05）. All symptoms and organ damage in patients were significantly alleviated. Conclusions Immunoadsorption therapy can rapidly and effectively remove autoantibodies and lipid, which can control the disease condition and protect the function of the impaired organs, and has a good therapeutic effect for a variety of autoimmune diseases and hyperlipidemia.

关 键 词：免疫吸附技术 治疗 临床研究性 自身免疫性疾病 高脂血症 

分 类 号：R746.105[医药卫生—神经病学与精神病学] R593.2[医药卫生—临床医学]