DNA免疫吸附序贯联合免疫抑制剂治疗系统性红斑狼疮的临床观察  

Clinical observation of sequential DNA immunoadsorption and immunosuppressant in the treatment of systemic lupus erythematosus

作　　者：董莉[1] 万琦[1] 陈盼[1] 张蓉[1] 江涛[2] 李荣达[1] 毛捷 DONG Li;WAN Qi;CHEN Pan;ZHANG Rong;JIANG Tao;LI Rong-da;MAO Jie(1Department of Rheumatology and Immunology,Jingzhou Central Hospital(Jingzhou Hospital,Yangtze University),Hubei Jingzhou 434020,China;Department of Clinical Laboratory,Jingzhou Central Hospital(Jingzhou Hospital,Yangtze University),Hubei Jingzhou 434020,China)

机构地区：[1]荆州市中心医院(长江大学附属荆州医院)风湿免疫科,湖北荆州434020 [2]荆州市中心医院(长江大学附属荆州医院)医学检验部,湖北荆州434020

出　　处：《内科急危重症杂志》2022年第2期108-112,共5页Journal of Critical Care In Internal Medicine

基　　金：荆州市科技计划发展项目(No:2018083)。

摘　　要：目的:观察DNA免疫吸附治疗对系统性红斑狼疮(SLE)患者抗dsDNA抗体的清除作用以及序贯联合免疫抑制剂治疗的疗效反应。方法:收集2017年8月至2021年8月荆州市中心医院风湿免疫科收治的SLE患者,选择体内抗dsDNA抗体高滴度阳性的活动期SLE患者36例,常规治疗基础上联合DNA免疫吸附治疗,观察患者治疗前、后自身抗体及血液生化指标的变化,吸附治疗后给予免疫抑制剂,随访至少12周。结果:吸附治疗后患者体内抗dsDNA抗体滴度显著下降,平均降幅(66.4%±12.8%),高滴度抗核抗体的患者显著减少。随访中,33例患者病情维持稳定,3例患者在1~2年后,抗dsDNA抗体再次上升,重复行DNA免疫吸附治疗,病情稳定。结论:DNA免疫吸附可以在短期内明显清除抗dsDNA抗体,有助于快速缓解病情,序贯联合免疫抑制剂治疗有助于实现疾病的长期稳定。Objective:To observe the curative effect of DNA immunoadsorption on the clearance of anti-dsDNA antibodies in patients with systemic lupus erythematosus(SLE)and the efficacy response to sequential therapy combined with immunosuppressant therapy.Methods:A total of 36 patients with active SLE with high titer anti-dsDNA antibody were collected from Department of Rheumatology and Immunology of Jingzhou Central Hospital from August 2017 to August 2021.Patients were treated with DNA immunoadsorption on the basis of conventional treatment.The changes of autoantibodies and blood biochemical indicators were observed before and after treatment.Immunosuppressants were given after adsorption treatment.The patients were followed up for at least 12 weeks.Results:The titer of anti-dsDNA antibody in patients decreased significantly after DNA immunoadsorption therapy,with an average decrease of(66.4%±12.8%),and the number of patients with high titer of ANA decreased significantly.During the follow-up,33 patients remained stable,and anti-dsDNA antibody in 3 patients increased again after 1 to 2 years,with repeated DNA immunoadsorption treatment and a stable condition.Conclusion:DNA immunoadsorption can significantly eliminate anti-dsDNA antibody in a short period of time,which is helpful to rapid remission of the disease,and sequential therapy in combination with immunosuppressant can help patients achieve long-term stability of the disease.

关 键 词：DNA免疫吸附 抗DSDNA抗体 免疫抑制剂 

分 类 号：R593.24[医药卫生—内科学]