摘要
目的 观察体外免疫吸附（ＥＩＡ） 对狼疮肾炎（ＬＮ） 的治疗和肾脏保护作用。方法 比较树脂型ＥＩＡ、大剂量激素和ＣＴＸ联合治疗（ 简称ＥＩＡ组）与大剂量激素和ＣＴＸ治疗（ 简称对照组） 血ＩｇＧ、ＡＮＡ、ｄｓＤＮＡ、Ｃ３、２４ 小时尿蛋白、ＢＵＮ、Ｓｃｒ 及其他临床指标的变化。结果 治疗２ 周时，ＥＩＡ组血ＩｇＧ、ＡＮＡ、ｄｓＤＮＡ显著低于对照组［ 两组分别为ＩｇＧ（１０－０３ ±２－９１） 、（１３－５４ ±３－０５）ｇ／Ｌ，ＡＮＡ（１４－００ ±１３－１４）、（３１－８２ ±３０－０２）ｔｉｔｅｒ－ １，ｄｓＤＮＡ（８－３０ ±４－８３） 、（２７－００ ±１８－５１） ％］ 。Ｃ３ 显著回升［ 两组分别为（５８７－３±９７－０３） 、（４８１－５±１３２－０４）ｍｇ／Ｌ］，２４ 小时尿蛋白、ＢＵＮ、Ｓｃｒ 显著低于对照组［ 两组分别为２４ 小时尿蛋白（２－２８±２－０７） 、（５－９８ ±３－３４）ｇ／２４ｈ，ＢＵＮ（９－１７ ±２－８３）、（１５－２９ ±５－３８）ｍｍｏｌ／Ｌ、Ｓｃｒ（１５６－７５ ±８９－３３）、（２４７－１４±７４－６９）μｍｏｌ／Ｌ） 。治疗４ 周时，ＥＩＡ 组血ＩｇＧ、ｄｓＤＮＡ 仍低于对照组［
Objective To investigate the therapeutic and renal protective effects of resin type extracorporeal immunoadsorption (EIA) on lupus nephritis (LN).Methods Blood levels of IgG, dsDNA antibody, C 3, urine protein of 24 hours, BUN,creatinine and other clinical indexes were compared in EIA, high dose steroid, cyclophosphamide (CTX) therapy (EIA group) with those in high dose steroid, CTX therapy (control group).Results After 2 weeks of therapy, the levels of IgG, ANA, dsDNA antibody were lower markedly in EIA group than those in control group [IgG (10 03±2 91/13 54±3 05)g/L,ANA (14 00±13 14/31 82±30 02)titer -1 ,dsDNA(8 30±4 83/27 00±18 51)% respectively]. The level of C 3 was higher in EIA group[(587 30±97 03/481 50±132 04)mg/L]. The levels of 24 hours urine protein, BUN, serum creatinine were lower markedly in EIA group[24 hours urine protein(2 28±2 07/5 98±3 34)g/24 h,BUN(9 17±2 83/15 29±5 38)mmol/L,Scr (156 75±89 33/247 14±74 69)μmol/L respectively]. After 4 weeks of therapy, the levels of IgG, dsDNA were lower markedly in EIA group than those in control group [IgG (8 92±2 75/11 00±2 28)g/L,dsDNA(9 45±4 96/13 09±5 94)% respectively]. The levels of 24 hours urine protein, BUN, serum creatinine were lower in EIA group [24 hours urine protein (1 03±0 65/1 57±0 83)g/24 h、BUN (7 28±2 33/8 98±2 40)mmol/L、Scr(134 05±78 93/184 95±73 13)μmol/L respectively]. Conclusion Resin type EIA could selectively clear IgG type dsDNA antibody from patient’s blood of lupus nephritis, reduce deposition of immune complex in kidney.EIA in combination with high dose steroid and CTX therapy to lupus nephritis can enhance therapeutic effect, relieve renal lesion and have protective effect of renal function.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
1999年第6期361-364,共4页
Chinese Journal of Nephrology
关键词
狼疮肾炎
治疗
免疫吸附
Lupus nephritis Treatment Immunoadsorption
