DNA免疫吸附治疗儿童重度活动系统性红斑狼疮近期疗效研究  

Evaluation of Short-Term Therapeutic Effects of DNA Immunoadsorption Therapy in Children with Severe Systemic Lupus Erythematosus

作　　者：黄丹琳[1] 党西强[1] 刘东海[1] 钟艳兰[1] 易著文[1] 吴小川[1] 曹艳[1] 何庆南[1] 

机构地区：[1]中南大学湘雅二医院小儿肾脏病研究室湖南省小儿肾脏病临床中心,湖南省长沙市410011

出　　处：《中国全科医学》2011年第30期3431-3434,共4页Chinese General Practice

摘　　要：目的评价DNA免疫吸附(DNA immunoadsorption,DNA-IA)治疗儿童重度活动系统性红斑狼疮(SLE)的近期疗效。方法对12例儿童SLE患者进行DNA-IA治疗。所有患儿DNA-IA治疗前系统性红斑狼疮疾病活动度(SLEDAI)评分均>15分,为重度活动。11例患儿常规行3次DNA-IA治疗,1例行2次治疗。DNA-IA治疗前后行抗核抗体(ANA)、抗双链DNA(ds-DNA)抗体、红细胞沉降率、免疫球蛋白、补体、血常规、肝肾功能、24 h尿蛋白定量等检查。结果 DNA-IA治疗后患儿症状体征明显好转,SLEDAI评分明显下降,ANA滴度明显下降,抗ds-DNA抗体明显下降,补体C3明显上升,红细胞沉降率和血清IgG明显下降,尿蛋白定量明显下降,与治疗前比较差异均有统计学意义(P<0.05);血清IgA、IgM、补体C4、血常规、肝肾功能等无明显变化。DNA-IA过程中无一例出现严重并发症。结论 DNA-IA是治疗儿童重度活动SLE的有效方法,还需进一步的对照研究观察其远期疗效。Objective To evaluate the short-term therapeutic effects of DNA immunoadsorption（IA） therapy in children with severe systemic lupus erythematosus（SLE）.Methods DNA-IA was performed in 12 SLE patients,all scored above 15 in Systemic Lupus Erythematosus Disease Activity Index（SLEDAI） evaluation before treatment and were diagnosed as severely active.Eleven cases received routine DNA-IA therapy of 3 times,while the other case received DNA-IA therapy twice.Levels of anti-nuclear antibody（ANA）,ds-DNA,erythrocyte sedimentation rate（ESR）,immunoglobulin,complements,blood routine test,hepatic and renal function,and 24h-urinary protein were examined both before and after treatment.Results The symptoms and signs were improved after IA therapy with the SLEDAI scores,ANA titers,anti-ds-DNA antibody levels,ESR,serum IgG,and urinary protein decreased significantly while complement C3 increased on the other hand（P0.05）.No significant changes in serum IgA,IgM,C4,blood routine test,hepatic and renal function were noted.No serious complications during the IA process were found.Conclusion DNA-IA is effective in treating children with severe systemic lupus erythematosus and further studies have yet to be carried out to evaluate its long-term effects.

关 键 词：红斑狼疮 系统性 免疫吸附剂 治疗结果 

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