Retrospective Analysis of Plasma Exchange Combined with Glucocorticosteroids for the Treatment of Systemic Lupus Erythematosus-related Acute Pancreatitis in Central China  

作　　者：余毅恺 于飞 叶丛 戴玉洁 黄晓伟 胡绍先 

机构地区：[1]Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology [2]Department of Digestive Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

出　　处：《Journal of Huazhong University of Science and Technology(Medical Sciences)》2016年第4期501-508,共8页华中科技大学学报（医学英德文版）

基　　金：supported by a grant of Innovation Talents Development Fund of Wuhan Municipal Human Resources and Social Security Bureau,China(No.201402)

摘　　要：Systemic lupus erythematosus-related acute pancreatitis（SLEAP） has a poor prognosis with a high mortality. We described the clinical features of SLEAP, and discussed the feasibility of plasma exchange（PE） combined with glucocorticosteroids（GC） in short-term prognosis and possible mechanism in reducing serum inflammatory cytokine IL-6 and removing serum lipids. A retrospective study was performed by an independent rheumatologist. Medical records of SLEAP from March 2010 to December 2014 were retrieved from Tongji Hospital information system, and patients were divided into two groups according to whether PE therapy was adopted. Sixteen patients treated with PE in combination with GC were classified as group A, and the other 10 patients who were treated with merely GC were classified as group B. Patients＇ clinical remission rate and average daily GC dosage after two-week therapy were compared between the two groups. Patients＇ serum inflammatory cytokines and lipid concentration were compared between baseline and after two-week treatment in both groups. Pearson correlation test was performed to determine association between serum cytokines and Ranson score. SLEDAI score in group A patients at baseline（14.8±3.1） showed no statistical difference from that in group B（14.1±3.3）. At baseline serum IL-6 levels had no significant difference between group A [13.14（11.12, 16.57） mg/L] and group B [14.63（11.37, 16.37） mg/L]; after two-week therapy IL-6 decreased significantly in group A [9.16（7.93, 10.75）mg/L] while it did not show decreasing trend in group B [13.62（9.29,17.63） mg/L]. Serum lipid concentration after two-week therapy in group A [（TC=5.02±0.53, TG=1.46±0.44） mmol/L] decreased significantly compared to baseline [（TC=6.11±0.50, TG=2.14±1.03） mmol/L], while similar tendency was not observed in group B. The remission rate after two-week therapy was higher in group A（70.0%） than in group B（25.0%）. Acute pancreatitis（AP） was one of the clinical manifestSystemic lupus erythematosus-related acute pancreatitis（SLEAP） has a poor prognosis with a high mortality. We described the clinical features of SLEAP, and discussed the feasibility of plasma exchange（PE） combined with glucocorticosteroids（GC） in short-term prognosis and possible mechanism in reducing serum inflammatory cytokine IL-6 and removing serum lipids. A retrospective study was performed by an independent rheumatologist. Medical records of SLEAP from March 2010 to December 2014 were retrieved from Tongji Hospital information system, and patients were divided into two groups according to whether PE therapy was adopted. Sixteen patients treated with PE in combination with GC were classified as group A, and the other 10 patients who were treated with merely GC were classified as group B. Patients＇ clinical remission rate and average daily GC dosage after two-week therapy were compared between the two groups. Patients＇ serum inflammatory cytokines and lipid concentration were compared between baseline and after two-week treatment in both groups. Pearson correlation test was performed to determine association between serum cytokines and Ranson score. SLEDAI score in group A patients at baseline（14.8±3.1） showed no statistical difference from that in group B（14.1±3.3）. At baseline serum IL-6 levels had no significant difference between group A [13.14（11.12, 16.57） mg/L] and group B [14.63（11.37, 16.37） mg/L]; after two-week therapy IL-6 decreased significantly in group A [9.16（7.93, 10.75）mg/L] while it did not show decreasing trend in group B [13.62（9.29,17.63） mg/L]. Serum lipid concentration after two-week therapy in group A [（TC=5.02±0.53, TG=1.46±0.44） mmol/L] decreased significantly compared to baseline [（TC=6.11±0.50, TG=2.14±1.03） mmol/L], while similar tendency was not observed in group B. The remission rate after two-week therapy was higher in group A（70.0%） than in group B（25.0%）. Acute pancreatitis（AP） was one of the clinical manifest

关 键 词：systemic lupus erythematosus acute pancreatitis plasma exchange IL-6 serum lipid 

分 类 号：R593.241[医药卫生—内科学] R576[医药卫生—临床医学]