双冲击疗法联合DNA免疫吸附柱治疗狼疮性肾炎的研究  

Study of double pulse therapy combined with DNA immune absorb post on lupus nephritis

作　　者：李政[1] 赵勇智[1] 王杰[1] 苏莉[1] 魏少敏[1] 张艳娟[1] 于有波[1] 

机构地区：[1]辽宁省普兰店市中心医院,辽宁普兰店116200

出　　处：《现代中西医结合杂志》2009年第34期4192-4193,共2页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：大连市2006年第一批医学卫生科学研究计划项目(2006088)

摘　　要：目的观察双冲击疗法联合DNA免疫吸附柱治疗狼疮性肾炎（LN）的临床效果。方法将LN患者随机分为2组：对照组在常规治疗的基础上应用双冲击疗法,即甲基泼尼松和环磷酰胺（CTX）冲击;治疗组在此基础上联合应用DNA免疫吸附柱,血流量150~200 mL/min,时间2 h,可间隔5~7 d后进行第2次免疫吸附,一般吸附2~3次。观察2组治疗前后抗核抗体（ANA）、抗双链DNA抗体（ds-DNA）、血尿常规、肝肾功能、血离子、免疫球蛋白、补体及临床表现变化和不良反应发生情况。结果治疗组ANA转阴率和ds-DNA转阴率均显著高于对照组。治疗1个月后治疗组尿蛋白定量和血免疫球蛋白IgG显著低于对照组（P均〈0.05）;临床表现治疗组均有所改善,对照组则改善不明显。2组血常规、血清转氨酶、血浆蛋白、血离子和补体C3、C4各项指标均无显著改变。结论双冲击疗法联合DNA免疫吸附柱治疗能很好地清除LN患者体内的ANA和ds-DNA抗体,缓解临床症状,有利于蛋白尿的降低和肾功能的改善。Objective It is to observe the clinical effect of double pulse therapy combined with DNA immune absorb post on lupus nephritis（LN）.Methods The patients with LN were randomly divided into 2 groups： control group was treated with double pulse therapy（Methyllprednisolone and CTX） on the basis of normal treatment.Treatment group was added with DNA immune absorb post（blood flow： 150-200 mL/min,time：2h） for 2-3 times on the basis above.The second immune absorb post could be performed on 5-7 days later.The changes of ANA, ds- DNA, normal examination of blood and urine, liver and kidney function, blood ions, immunoglobulin, complement and clinical syndromes and side effect in the two groups were observed before and after treatment. Results The negative rates of ANA and ds- DNA in treatment group were higher than that of in control group. In treatment group, urine protein and serum immunoglobulin IgG were decreased obviously, compared with that in control group, the difference was significant （P 〈 0.05 ）. All the clinical syndromes in treatment group were improved, but not obviously in control group. There was no significant difference in the indexes such as blood normal examination, serum transaminase, plasma protein, blood ions and complement C3 and C4. Conclusion The treatment with double pulse therapy combinecl with DNA immune absorb post for LN is not radical, but it can well clear ANA and ds- DNA antibody, relieve clinical syndromes in patients with LN, and is benefit for the decreasing of urine protein and improving of kidney function.

关 键 词：双冲击疗法 DNA免疫吸附 狼疮性肾炎 自身抗体 蛋白尿 

分 类 号：R059.324.2[医药卫生]