中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2014年
2期
84-87
,共4页
吴潮清%熊礼佳%贺红光%刘芸芳%李瑾瑜%王浩宇%唐盛%叶琨%彭小梅%黄玲%唐业莹
吳潮清%熊禮佳%賀紅光%劉蕓芳%李瑾瑜%王浩宇%唐盛%葉琨%彭小梅%黃玲%唐業瑩
오조청%웅례가%하홍광%류예방%리근유%왕호우%당성%협곤%팽소매%황령%당업형
DNA免疫吸附%系统性红斑狼疮疾病活动度评分%健康状况评价%抗双链DNA抗体%免疫球蛋白%超敏C-反应蛋白%补体
DNA免疫吸附%繫統性紅斑狼瘡疾病活動度評分%健康狀況評價%抗雙鏈DNA抗體%免疫毬蛋白%超敏C-反應蛋白%補體
DNA면역흡부%계통성홍반랑창질병활동도평분%건강상황평개%항쌍련DNA항체%면역구단백%초민C-반응단백%보체
DNA immunoadsorbent%Systemic lupus erythematosus%Systemic lupus erythematosus disease activity index score%Health evaluation%Anti-double stranded DNA antibody%Immunoglobulin%High-sensitivity C-reactive protein%Complement
目的:观察DNA免疫吸附联合激素和免疫抑制剂治疗重度系统性红斑狼疮(SLE)的近期疗效。方法选择32例重度活动期SLE患者,采用DNA免疫吸附联合糖皮质激素+环磷酰胺治疗,免疫吸附治疗共3次,每次2.5 h,间隔24~48 h进行随后的2次免疫吸附。治疗前及吸附治疗结束2周后观察SLE疾病活动度指数(SLEDAI)评分、健康状况评价指标〔生理功能(PF)和精神健康(MH)评分〕、肾功能指标〔血尿素氮(BUN)和血清肌酐(SCr)〕的变化;并检测抗双链DNA抗体(dsDNA)、免疫球蛋白(IgA、IgG、IgM)、补体(C3和C4)、超敏C-反应蛋白(hs-CRP)等变化。结果联合用药治疗2周后,患者SLEDAI评分、BUN、SCr、dsDNA、IgA、IgG、IgM、hs-CRP均较治疗前明显降低〔SLEDAI评分(分):14.38±3.85比15.69±1.40,BUN (mmol/L):11.22±4.78比16.31±7.90,SCr(μmol/L):127.02±38.17比167.25±45.63,dsDNA(U/L):1.36±0.12比1.43±0.18,IgA(g/L):2.41±0.73比2.59±0.86,IgG(g/L):16.82±4.83比21.01±4.84,IgM(g/L):1.64±0.45比1.75±0.58,hs-CRP(mg/L):14.41±2.20比14.94±2.60,P<0.05或P<0.01〕;PF评分、MH评分、C3均升高〔PF评分(分):71.19±17.53比56.66±22.41,MH评分(分):74.01±15.72比61.50±17.98,C3(g/L):0.56±0.09比0.52±0.10,均P<0.05〕;临床症状明显好转,无明显不良反应发生。结论免疫吸附联合药物治疗重度活动期SLE近期疗效显著,能降低dsDNA、IgA、IgG、IgM、hs-CRP水平,升高补体C3水平。
目的:觀察DNA免疫吸附聯閤激素和免疫抑製劑治療重度繫統性紅斑狼瘡(SLE)的近期療效。方法選擇32例重度活動期SLE患者,採用DNA免疫吸附聯閤糖皮質激素+環燐酰胺治療,免疫吸附治療共3次,每次2.5 h,間隔24~48 h進行隨後的2次免疫吸附。治療前及吸附治療結束2週後觀察SLE疾病活動度指數(SLEDAI)評分、健康狀況評價指標〔生理功能(PF)和精神健康(MH)評分〕、腎功能指標〔血尿素氮(BUN)和血清肌酐(SCr)〕的變化;併檢測抗雙鏈DNA抗體(dsDNA)、免疫毬蛋白(IgA、IgG、IgM)、補體(C3和C4)、超敏C-反應蛋白(hs-CRP)等變化。結果聯閤用藥治療2週後,患者SLEDAI評分、BUN、SCr、dsDNA、IgA、IgG、IgM、hs-CRP均較治療前明顯降低〔SLEDAI評分(分):14.38±3.85比15.69±1.40,BUN (mmol/L):11.22±4.78比16.31±7.90,SCr(μmol/L):127.02±38.17比167.25±45.63,dsDNA(U/L):1.36±0.12比1.43±0.18,IgA(g/L):2.41±0.73比2.59±0.86,IgG(g/L):16.82±4.83比21.01±4.84,IgM(g/L):1.64±0.45比1.75±0.58,hs-CRP(mg/L):14.41±2.20比14.94±2.60,P<0.05或P<0.01〕;PF評分、MH評分、C3均升高〔PF評分(分):71.19±17.53比56.66±22.41,MH評分(分):74.01±15.72比61.50±17.98,C3(g/L):0.56±0.09比0.52±0.10,均P<0.05〕;臨床癥狀明顯好轉,無明顯不良反應髮生。結論免疫吸附聯閤藥物治療重度活動期SLE近期療效顯著,能降低dsDNA、IgA、IgG、IgM、hs-CRP水平,升高補體C3水平。
목적:관찰DNA면역흡부연합격소화면역억제제치료중도계통성홍반랑창(SLE)적근기료효。방법선택32례중도활동기SLE환자,채용DNA면역흡부연합당피질격소+배린선알치료,면역흡부치료공3차,매차2.5 h,간격24~48 h진행수후적2차면역흡부。치료전급흡부치료결속2주후관찰SLE질병활동도지수(SLEDAI)평분、건강상황평개지표〔생리공능(PF)화정신건강(MH)평분〕、신공능지표〔혈뇨소담(BUN)화혈청기항(SCr)〕적변화;병검측항쌍련DNA항체(dsDNA)、면역구단백(IgA、IgG、IgM)、보체(C3화C4)、초민C-반응단백(hs-CRP)등변화。결과연합용약치료2주후,환자SLEDAI평분、BUN、SCr、dsDNA、IgA、IgG、IgM、hs-CRP균교치료전명현강저〔SLEDAI평분(분):14.38±3.85비15.69±1.40,BUN (mmol/L):11.22±4.78비16.31±7.90,SCr(μmol/L):127.02±38.17비167.25±45.63,dsDNA(U/L):1.36±0.12비1.43±0.18,IgA(g/L):2.41±0.73비2.59±0.86,IgG(g/L):16.82±4.83비21.01±4.84,IgM(g/L):1.64±0.45비1.75±0.58,hs-CRP(mg/L):14.41±2.20비14.94±2.60,P<0.05혹P<0.01〕;PF평분、MH평분、C3균승고〔PF평분(분):71.19±17.53비56.66±22.41,MH평분(분):74.01±15.72비61.50±17.98,C3(g/L):0.56±0.09비0.52±0.10,균P<0.05〕;림상증상명현호전,무명현불량반응발생。결론면역흡부연합약물치료중도활동기SLE근기료효현저,능강저dsDNA、IgA、IgG、IgM、hs-CRP수평,승고보체C3수평。
Objective To evaluate the short-term therapeutic effects of DNA immunoadsorbent (IA) combined with glucocorticoid and immune depressant on patients with severe systemic lupus erythematosus(SLE). Methods 32 patients with severe SLE were selected to undergo DNA IA treatment combined with glucocorticoid plus cyclophosphamide therapy, and each patient received IA therapy 3 times, once 2.5 hours, with an interval of 24-48 hours to take another two times of IA. The changes in SLE disease activity index(SLEDAI)score, health status evaluation indexes〔 physiologic functional( PF) and emotional health( MH) scores〕,renal function indexes〔 blood urea nitrogen(BUN)and serum creatinine(SCr)〕 were observed; and anti-double stranded DNA antibody( ds-DNA), immunoglobulin (IgA, IgG, IgM), complements(C3 and C4)and high-sensitivity C-reactive protein (hs-CRP) were examined before and after IA treatment for 2 weeks. Results Two weeks after the combination therapy, the SLEDAI score, BUN, SCr, dsDNA, IgA, IgG, IgM, hs-CRP were significantly lower than those before treatment 〔SLEDAI score : 14.38±3.85 vs. 15.69±1.40, BUN (mmol/L): 11.22±4.78 vs. 16.31±7.90, SCr (μmol/L): 127.02±38.17 vs. 167.25±45.63, dsDNA( U/L): 1.36±0.12 vs. 1.43±0.18, IgA( g/L): 2.41±0.73 vs. 2.59±0.86, IgG( g/L): 16.82±4.83 vs. 21.01±4.84, IgM( g/L): 1.64±0.45 vs. 1.75±0.58, hs-CRP( mg/L): 14.41±2.20 vs. 14.94±2.60, P<0.05 or P<0.01〕; PF score, MH score, complement C3 were increased〔 PF score : 71.19±17.53 vs. 56.66±22.41, MH score : 74.01±15.72 vs. 61.50±17.98, C3( g/L): 0.56±0.09 vs. 0.52±0.10, all P<0.05〕; clinical symptoms were improved significantly, and no significant adverse reactions were found. Conclusion IA combined with medical treatment has shown that it has significant therapeutic effect for treatment of patients with severe SLE, and it may decrease the levels of dsDNA, IgA, IgG, IgM,hs-CRP, and increase the level of complement C3.