应用双重血浆分子吸附系统成功救治狼疮危象1例  

One case of lupus crisis was successfully treated with dual plasma molecular adsorption system

作　　者：谭植华[1] 杨彬 程友林[1] 魏栋[1] 李丛[1] Tan Zhihua;Yang Bin;Cheng Youlin;Wei Dong;Li Cong(Department of lntensive Care Uni,Shouguang People's Hospital,Weifang 262700,Shandong,China)

机构地区：[1]寿光市人民医院重症医学科,山东潍坊262700

出　　处：《中国中西医结合急救杂志》2022年第3期371-372,共2页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：狼疮危象是系统性红斑狼疮(SLE)病情加重的严重状态,病情进展迅速且病死率高,是临床治疗的难点.寿光市人民医院重症医学科于2021年3月21日收治1例狼疮危象患者,主要表现为胸闷、憋气、少尿,检查提示心力衰竭、呼吸衰竭、肺水肿、肾功能损伤,入住重症监护病房(ICU)抢救,采用连续性肾脏替代治疗(CRRT)清除水分及代谢废物,维持内环境稳定,第2日采用双重血浆分子吸附系统(DPMAS)分离血浆并吸附各种毒素、免疫复合物及部分抗体,行DNA免疫吸附柱吸附,序贯治疗3次.同时给予甲泼尼龙冲击、人免疫球蛋白+羟氯喹、抗感染、利尿、补充蛋白、加强营养等治疗后,患者最终顺利出院.Lupus crisis is a serious disease state of an aggravation of systemic lupus erythematosus(SLE),with rapid progression,high mortality and dificuly in clinical treatment.A patient with lupus crisis was admitted into the Department of Intensive Care Medicine of Shouguang people's hospital on March 21,2021,The patient main symptoms and signs were chest tightness,feeling of suffocation,oliguria;after examinations it was suggested that manifestations of heart failure,respiratory failure,pulmonary edema,kidney function injury were present,thus the patient was immediately rescued in the intensive care unit(ICU).Continuous renal replacement therapy(CRRT)was applied to remove water and metabolic waste,and maintain internal environment stability on the second day,dual plasma molecular adsorption system(DPMAS)was used to separate plasma and adsorb various toxins,immune complexes and partial antibodies,and DNA immunoadsorption column adsorption was carried out,the sequential treatment being used for 3 times.At the same time,methylprednisolone shock,human immunoglobulin+hydroxychloroquine,anti-infection,diuresis,protein supplementation and nutrition enhancement were given for the treatment finally the patient was discharged smothly.

关 键 词：系统性红斑狼疮 狼疮危象 双重血浆分子吸附系统 

分 类 号：R593.241[医药卫生—内科学]