CAJ | 학술논문

目的：观察静脉注射中等剂量丙种球蛋白(IVIG)治疗狼疮性肾炎并细菌感染的临床效果及副反应。方法：27例病人为2010年～2013年我院住院病人，诊断为狼疮性肾炎并细菌感染。肾功好转程度IVIG组16例给予：①IVIG200mg,/(kg?d)，连续用3～5天；②小剂量激素治疗，强的松0.4mg/(kg?d)，严重者甲基强的松龙冲击治疗。③抗生素治疗，根据药敏选择抗生素，或合成青霉素或三代头孢，如皮试阳性选用喹诺酮类抗生素。对照组11例予：仅应用上述小剂量激素治疗加抗生素治疗。3-4周根据SLE活动积分及相关临床征象比较两组临床治疗效果，并每周监测肝肾功、血常规等副反应。结果：治疗组SLE活动积分、尿蛋白下降程度及肾功好转程度显著高于对照组,体温下降至正常、及体征消失恢复正常时间显著低于对照组。治疗组监测副反应无明显肝功血液系统损害，1例因皮疹，考虑过敏反应退出，停药后症状缓解。结论：中等剂量丙种球蛋白冲击治疗SLE合并细菌感染能缩短感染时间，提高疗效缩短病情缓解时间，可以获得较明显的临床效果，副反应轻微。
목적：관찰정맥주사중등제량병충구단백(IVIG)치료랑창성신염병세균감염적림상효과급부반응。방법：27례병인위2010년～2013년아원주원병인，진단위랑창성신염병세균감염。신공호전정도IVIG조16례급여：①IVIG200mg,/(kg?d)，련속용3～5천；②소제량격소치료，강적송0.4mg/(kg?d)，엄중자갑기강적송룡충격치료。③항생소치료，근거약민선택항생소，혹합성청매소혹삼대두포，여피시양성선용규낙동류항생소。대조조11례여：부응용상술소제량격소치료가항생소치료。3-4주근거SLE활동적분급상관림상정상비교량조림상치료효과，병매주감측간신공、혈상규등부반응。결과：치료조SLE활동적분、뇨단백하강정도급신공호전정도현저고우대조조,체온하강지정상、급체정소실회복정상시간현저저우대조조。치료조감측부반응무명현간공혈액계통손해，1례인피진，고필과민반응퇴출，정약후증상완해。결론：중등제량병충구단백충격치료SLE합병세균감염능축단감염시간，제고료효축단병정완해시간，가이획득교명현적림상효과，부반응경미。
Objective To evaluate the efficacy and indications of medium dose intravenous immunoglobulin(IVIG)in patients with lupus nephritis (LN)complicating infection.Methods Twenty-seven patients with lupus nephritis (LN)complicating infection were divided into two groups: IVIG[IVIG at a dosage of 200 mg/(kg d) for 3 to 5 consecutive days] with low dose of prednisone (0.4 mg/kg d) P) in 16 patients as group 1, and low dose of prednisone alone in 11 patients as group 2.The therapeutic efficacy of these two groups were compared by calculating SLE activity scoring, urine protein, eGFR,the time of temperature drop and signs disappearance, before and after treatments.Results SLE activity scoring and urine protein decreased more after the treatment in group 1 than in group 2. Renal function increased more in group 1 than in group 2. The time of temperature drop and signs disappearance was shorter in group 1 than in group 2.Within 3 to 4 weeks after initiation of IVIG therapy patients showed normal hepatic function and blood routine test.Only one patient showed skin rash and quit the therapy of IVIG. Conclusions IVIG is a potent adjuvant therapy for lupus nephritis complicating infection.