CAJ | 학술논문

[目的]观察血浆置换联合激素、霉酚酸酯（MMF）治疗儿童重症系统性红斑狼疮（SLE）的临床疗效。[方法]回顾性分析入住本院的18例重症S L E患儿的临床资料，观察治疗前后患儿症状、体征（发热、关节疼痛、皮疹、水肿）缓解情况及抗SM抗体、抗ds-DNA抗体、抗RNP抗体、血沉（ESR）、24h尿蛋白、肌酐（SCr）及补体C3的变化。[结果]18例患儿经治疗后症状全部得到好转，其中12例面部红斑消失，2例患儿皮肤表面溃疡愈合，13例患儿雷诺现象消失，发热及关节疼痛明显缓解。ESR由治疗前的（92±24）mm/h降到（27±15）mm/h ，24 h尿蛋白由治疗前的（8．12±4．76）g降到（1．83±1．55）g ，抗SM抗体、抗ds-DNA抗体转阴率明显下降。[结论]血浆置换联合激素、MMF可降低血清自身抗体，有效控制儿童重症SLE ，值得临床推广应用。
[목적]관찰혈장치환연합격소、매분산지（MMF）치료인동중증계통성홍반랑창（SLE）적림상료효。[방법]회고성분석입주본원적18례중증S L E환인적림상자료，관찰치료전후환인증상、체정（발열、관절동통、피진、수종）완해정황급항SM항체、항ds-DNA항체、항RNP항체、혈침（ESR）、24h뇨단백、기항（SCr）급보체C3적변화。[결과]18례환인경치료후증상전부득도호전，기중12례면부홍반소실，2례환인피부표면궤양유합，13례환인뢰낙현상소실，발열급관절동통명현완해。ESR유치료전적（92±24）mm/h강도（27±15）mm/h ，24 h뇨단백유치료전적（8．12±4．76）g강도（1．83±1．55）g ，항SM항체、항ds-DNA항체전음솔명현하강。[결론]혈장치환연합격소、MMF가강저혈청자신항체，유효공제인동중증SLE ，치득림상추엄응용。
[Objective] To observe the clinical efficacy of plasma exchange combined with corticoids and myco-phenolate mofetil(MMF) for the treatment of severe systemic lupus erythematosus (SLE) in children .[Methods]Clinical data of 18 children with severe SLE in our hospital were analyzed retrospectively .The improvement of symptoms and signs(fever ,joint pain ,rash ,edema) and anti-SM antibody ,anti-ds-DNA antibody ,anti-RNP anti-bodies ,blood sedimentation(ESR) ,24h urine protein ,serum creatinine(Scr) and complement C3 before and after treatment were observed .[Results]Symptoms of all the 18 patients got better after treatment .Facial erythema of 12 patients disappeared .Skin surface ulcer of 2 patients was healed .Raynaud phenomenon of 13 patients disap-peared ,and fever and joint pain were alleviated significantly .ESR reduced from (92 ± 24)mm/h to (27 ± 15)mm/h ,and 24h urinary protein reduced from (8 .12 ± 4 .76)g to (1 .83 ± 1 .55)g .The negative conversion rate of anti-SM antibody and anti-ds-DNA antibody decreased obviously .[Conclusion] Plasma exchange combined with corti-coids and MMF can reduce serum autoantibodies and control severe SLE in children ,so it is worthy of clinical pro-motion .