CAJ | 학술논문

目的评价静脉免疫球蛋白治疗难治性寻常型天疱疮的临床及其意义.方法经临床、病理和直接免疫荧光、间接免疫荧光确诊为活动期寻常型天疱疮的12例患者,每天静脉注射免疫球蛋白400 mg/kg,连续5天,每4周1次为1疗程.所有患者在治疗时停用环磷酰胺或硫唑嘌呤.结果 12例中10例在开始静脉免疫球蛋白冲击治疗1周后病情控制.4周后糖皮质激素剂量减少30%.11例无明显不良反应,仅1例患者在输液开始30分钟内出现头痛、面红、心动过速,调整输液速度后缓解.血清中抗桥粒芯糖蛋白抗体-3抗体浓度(滴度)迅速降低,1周下降54%,2周下降70%,3周下降78%.抗桥粒芯糖蛋白抗体-3抗体下降而总IgG水平不变.结论静脉免疫球蛋白可迅速控制难治性寻常型天疱疮病情,不良反应轻且有自限性,是治疗该病的有效方法之一.
목적 평개정맥면역구단백치료난치성심상형천포창적림상급기의의.방법 경림상、병리화직접면역형광、간접면역형광학진위활동기심상형천포창적12례환자,매천정맥주사면역구단백400 mg/kg,련속5천,매4주1차위1료정.소유환자재치료시정용배린선알혹류서표령.결과 12례중10례재개시정맥면역구단백충격치료1주후병정공제.4주후당피질격소제량감소30%.11례무명현불량반응,부1례환자재수액개시30분종내출현두통、면홍、심동과속,조정수액속도후완해.혈청중항교립심당단백항체-3항체농도(적도)신속강저,1주하강54%,2주하강70%,3주하강78%.항교립심당단백항체-3항체하강이총IgG수평불변.결론 정맥면역구단백가신속공제난치성심상형천포창병정,불량반응경차유자한성,시치료해병적유효방법지일.
Objective To evaluate the efficacy of intravenous immunoglobulin (IVIg) in the treatment of refractory pemphigus vulgaris (PV). Methods This study included 12 patients who were diagnosed as active PV by clinical and pathological examination as well as direct and indirect immunofluorescent test. All patients had been treated with high dose of steroids for one month but little improvement was achieved. Besides prednisone, patients were given IVIg 400 mg/kg once a day for 5 consecutive days with a 23-day interval as a treatment course during which the application of azathioprim or cyclophosphamide was stopped. The serum levels of antibodies to desmoglein 3 were detected by ELISA kits. The effects of IVIg were evaluated by the response of patients and required doses of prednisone. Side effects were also evaluated in these patients.Results Remission was achieved in 10 (83%) of the 12 patients one week after the treatment wtih IVIg. The dosage of prednisone declined by 30% 4 weeks later. Severe side effects were observed in none but 1 patient,who developed headache, flushing and tachycardia 30 minutes after the intravenous injection of immunoglobulin, whereas all symptoms were relieved after modulation of injection speed. Following the treatment, serum levels of antibodies to desmoglein 3 were rapidly decreased by 54% in week 1, 70% in week 2,78% in week 3, while the level of IgG remained unchanged. Conclusions Mg treatment combined with prednisone could rapidly control severe PV resistant to conventional therapies. Therefore, it may serve as an adjuvant treatment of PV.