血液净化联合DNA免疫吸附治疗重症系统性红斑狼疮的效果  

Effect of blood purification combined with DNA immunoadsorption in treatment of severe systemic lupus erythematosus

作　　者：鱼强[1] 刘岐焕[1] 程范军[1] 刘晓红[1] 张有顺[1] 

机构地区：[1]湖北医药学院附属东风总医院血液风湿科,湖北十堰442000

出　　处：《临床和实验医学杂志》2016年第6期560-562,共3页Journal of Clinical and Experimental Medicine

基　　金：湖北省卫生厅科研项目(20120214)

摘　　要：目的探讨连续性血液净化联合DNA免疫吸附配合泼尼松片、环磷酰胺治疗重症系统性红斑狼疮的效果与安全性。方法选取80例系统性红斑狼疮重症患者作为研究对象,将其均分为试验组与对照组。在常规药物治疗基础上,对照组应用DNA免疫吸附治疗,试验组给予连续性血液净化联合DNA免疫吸附治疗。对比分析两组疗效、肾功能指标及抗核抗体情况。结果试验组的总有效率(95.00%)明显高于对照组(62.50%)(P<0.01)。治疗2个月后,试验组的血尿素氮(5.31±1.25)mmol/L、血清肌酐(98.58±21.17)μmol/L明显优于对照组的血尿素氮(7.23±1.33)mmol/L、血清肌酐(128.38±25.76)μmol/L,差异具有统计学意义(P<0.05)。试验组ANA(1.62±0.41)、抗ds-DHA抗体(0.91±0.42)明显低于对照组2.21±0.69和1.21±0.62(P<0.05)。试验组患者不良反应发生率(7.50%)明显低于对照组(27.50%),差异具有统计学意义(P<0.05)。试验组抗核抗体敏感性为30.00%,明显低于对照组的62.50%,差异具有统计学意义(P<0.05)。结论血液净化联合DNA免疫吸附配合泼尼松片、环磷酰胺治疗重症系统性红斑狼疮的效果显著,改善患者肾功能,安全可靠,值得临床推广。Objective To analyze and explore the effect and safety of continuous blood purification combined with DNA immunoadsorption,prednisone tablets and cyclophosphamide in the treatment of severe systemic lupus erythematosus. Methods 80 patients with severe systemic lupus erythematosus treated in our hospital were taken as the research objects and were averagely divided into the experimental group and the control group. The control group were treated with DNA immunoadsorption,while the experimental group were treated with continuous blood purification combined with DNA immunoadsorption. The curative effect,renal function indexes and antinuclear antibody in the two groups were comparatively analyzed. Results The total effective rate in the experimental group（ 95. 00%） was significantly higher than that in the control group（ 62.50%）（ P〈0. 05）. 2 months of treatment later,the blood urea nitrogen（ 5. 31 ± 1. 25） mmol / L and serum creatinine（ 98. 58 ± 21. 17） μmol /L of the experimental group were significantly better than those of the control group[（ 7. 23 ± 1. 33） mmol / L and（ 128. 38 ± 25. 76） μmol / L]（P〈0. 05）. ANA（ 1. 62 ± 0. 41） and anti- ds- DHA antibody（ 0. 91 ± 0. 42） in the experimental group were significantly higher than those of the control group[（ 2. 21 ± 0. 69） and（ 1. 21 ± 0. 62） ]（ P〈0. 05）. The incidence of adverse reactions in the experimental group（ 7. 50%）was significantly lower than that in the control group（ 27. 50%）（ P〈0. 05）. Antinuclear antibody test group sensitivity of 30. 00% was significantly lower than the 62. 50% in the control group,the difference was statistically significant（ P〈0. 05）. Conclusion The effect of blood purification combined with DNA immunoadsorption in treatment of severe systemic lupus erythematosus is significant. It can improve the renal function of patients,safe and reliable. It is worthy of promotion.

关 键 词：重症系统性红斑狼疮 连续性血液净化 DNA免疫吸附 泼尼松片 环磷酰胺 

分 类 号：R593.241[医药卫生—内科学]