双重血浆置换治疗急性期自身免疫性疾病伴肾损伤的效果分析  

Effect analysis of dual plasma exchange in the treatment of acute autoimm une disease with renal injury

作　　者：管玺 刘同强[2] 郭山脉 GUAN Xi;LIU Tongqiang;GUO Shanmai(Medical Insurance Office,The Second People’s Hospital of Changzhou,Changzhou Jiangsu 213004;Nephrology Department,The Second People’s Hospital of Changzhou,Changzhou Jiangsu 213004)

机构地区：[1]江苏省常州市第二人民医院医保办公室,江苏常州213004 [2]江苏省常州市第二人民医院肾内科,江苏常州213004

出　　处：《当代医药论丛》2023年第2期84-87,共4页

基　　金：江苏省2020年高层次卫生人才“六个一工程”拔尖人才科研项目,项目编号:LCY2020035。

摘　　要：目的:探讨并观察对急性期自身免疫性疾病(AID)伴肾损伤患者进行双重血浆置换(DFPP)治疗的效果。方法:回顾性分析江苏省常州市第二人民医院2021年1月至2022年4月期间收治的25例急性期AID伴肾损伤患者的临床资料。对这些患者均进行DFPP治疗,对比治疗前后患者肾功能指标、免疫指标及其他血生化指标的变化情况。结果:与治疗前比较,治疗后25例患者血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)和补体C3的水平均显著降低,差异有统计学意义(P<0.05)。与治疗前比较,治疗后25例患者血清肌酐(Scr)、血尿素氮(BUN)、尿酸(UA)的水平均显著降低,差异有统计学意义(P<0.05)。与治疗前比较,治疗后25例患者纤维蛋白原(FIB)的水平显著降低,差异有统计学意义(P<0.05)。治疗前后,25例患者血小板计数、血红蛋白(Hb)、血钾、血钠的水平变化不明显,差异无统计学意义(P>0.05)。结论:对急性期AID伴肾损伤患者进行DFPP治疗可迅速清除体内的致病性抗体,从而有效缓解肾脏损伤,治疗相对安全可靠,但治疗期间需注意监测患者的凝血功能。Objective:To investigate and observe the effect of dual plasma exchange(DFPP)in patients with acute autoimmune disease(AID)with renal injury.Methods:The clinical data of 25 patients with acute AID accompanied by kidney injury admitted to the Second People’s Hospital of Changzhou City,Jiangsu Province from January 2021 to April 2022 were retrospectively analyzed.All these patients were treated with DFPP,and the changes of renal function indexes,immune indexes and other blood biochemical indexes before and after treatm ent were compared.Results:Compared with before treatment,the levels of serum immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)and complement C3 in 25 patients after treatment were significantly decreased,with statistical significance(P<0.05).Compared with before treatment,the levels of serum creatinine(Scr),blood urea nitrogen(BUN)and uric acid(UA)in 25 patients were significantly decreased after treatment,with statistical significance(P<0.05).Compared with before treatment,the level of fibrinogen(FIB)in 25 patients after treatment was significantly decreased,and the difference was statistically significant(P<0.05).Before and after treatment,there were no significant changes in platelet count,hemoglobin(Hb),blood potassium and blood sodium levels in 25 patients(P>0.05).Conclusion:DFPP treatment in patients with acute AID accompanied by kidney injury can quickly remove pathogenic antibodies in the body,thus effectively alleviating kidney injury.The treatment is relatively safe and reliable,but the coagulation function of patients should b e monitored during treatment.

关 键 词：双重血浆置换 自身免疫性疾病 肾损伤 免疫 

分 类 号：R593.2[医药卫生—内科学]