大剂量静脉滴注免疫球蛋白对系统性红斑狼疮继发血小板减少患者炎性因子水平及免疫功能的影响  

Effect of high-dose intravenous infusion of immunoglobulin on inflammatory factor levels and immune function in patients with thrombocytopenia secondary to systemic lupus erythematosus

作　　者：蒋艳 潘楠楠 马家胜 JIANG Yan;PAN Nannan;MA Jiasheng(Department of Rheumatology and Immunology,Puyang Oilfield General Hospital,Puyang,Henan 457000,China)

机构地区：[1]濮阳市油田总医院风湿免疫科,河南濮阳457000

出　　处：《中国医学工程》2021年第6期58-61,共4页China Medical Engineering

摘　　要：目的探究大剂量静脉滴注免疫球蛋白对系统性红斑狼疮继发血小板减少患者炎性因子水平及免疫功能的影响。方法选取濮阳市油田总医院风湿免疫科2017年1月至2019年8月期间95例系统性红斑狼疮继发血小板减少患者,根据随机数字表法分组。对照组47例给予环磷酰胺静脉滴注、强的松口服、甲基强的松龙冲击治疗,观察组48例增加大剂量静脉滴注免疫球蛋白,3个月后比较两组患者临床疗效;炎性因子水平:白细胞介素-4 (IL-4)、白细胞介素-10 (IL-10)、肿瘤坏死因子-α(TNF-α)和γ-干扰素(INF-γ)水平;免疫功能:免疫球蛋白A (IgA)、免疫球蛋白M (IgM)、免疫球蛋白G(IgG)、补体成分3 (C3)、补体成分4 (C4)水平;血小板改善效果:血小板达高峰平均时间和血小板上50%以上的占比;不良反应。结果治疗后观察组总有效率95.83%高于对照组78.72%,IL-4、IL-10、TNF-α、INF-γ、IgA、IgM、IgG水平低于对照组,补体C3、C4水平高于对照组(P<0.05)。观察组不良反应发生率10.42%高于对照组6.38%(P>0.05)。结论 HDIVIg对SLE继发血小板减少患者治疗,可降低炎症反应,改善免疫功能,提升血小板恢复时间和数量,药物安全性高。【Objective】To investigate the effect of high-dose intravenous infusion of immunoglobulin on the level of inflammatory factors and immune function in patients with thrombocytopenia secondary to systemic lupus erythematosus.【Methods】Ninety-five patients with thrombocytopenia secondary to systemic lupus erythematosus from January 2017 to August 2019 were selected and grouped according to the random number table method.The control group of 47 patients received cyclophosphamide intravenous infusion,prednisone oral administration,and methylprednisolone shock treatment.The observation group of 48 patients received high-dose intravenous infusion of immunoglobulin.Efficacy;inflammatory factor levels:IL-4,IL-10,TNF-αand INF-γlevels;immune function:IgA,IgM,IgG,complement C 3,C 4 levels;platelet improvement effect:average time of platelet peak and platelet more than 50%of the proportion;adverse reactions between the two groups were compared after 3 months.【Results】The total effective rate of the observation group after treatment(95.83%)was higher than that of the control group(78.72%).The levels of IL-4,IL-10,TNF-α,INF-γ,IgA,IgM and IgG of the observation group were lower than those of the control group and the levels of complement C 3 and C 4 were higher in the observation group than in the control group,with statistical significance(P<0.05).The incidence of adverse reactions in the observation group(10.64%)was higher than that in the control group(6.25%),which was not statistically significant(P>0.05).【Conclusion】The treatment of HDIVIg in patients with thrombocytopenia secondary to systemic lupus erythematosus can reduce inflammation,improve immune function,increase platelet recovery time and number,and have high drug safety.

关 键 词：大剂量 静脉滴注免疫球蛋白 系统性红斑狼疮 血小板减少 

分 类 号：R593.24[医药卫生—内科学]