中国中西医结合肾病杂志
中國中西醫結閤腎病雜誌
중국중서의결합신병잡지
CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN NEPHROLOGY
2014年
12期
1076-1078
,共3页
血浆置换%抗中性粒细胞胞质抗体相关性血管炎%高迁移率族蛋白-1
血漿置換%抗中性粒細胞胞質抗體相關性血管炎%高遷移率族蛋白-1
혈장치환%항중성립세포포질항체상관성혈관염%고천이솔족단백-1
Plasmapheresis%ANCA-associated vasculitis%HMGB1
目的：观察血浆置换对抗中性粒细胞胞质抗体相关性血管炎（ ANCA-associated vasculitis，AAV）外周血高迁移率族蛋白-1（highmobility group box chromosomal protein 1，HMGB1）的影响。方法：13例活动期 AAV患者，男10例，女3例，年龄41岁～76岁，BVAS评分（21．8±4．9）分，其中11例p／MPO-ANCA阳性，2例c／PR3-ANCA阳性，ANCA水平（295．78±52．76）RU／mL。均给予糖皮质激素及其冲击疗法等治疗基础上，辅以血浆置换。分别留取血浆置换治疗前空腹（TO）、治疗开始后2 h（T1）、血浆置换停止后12 h（T2）患者静脉血标本，分离血清后采用ELISA法检测其中的HMGB1。结果：本组患者行血浆置换后2 h血清HMGB1水平（3．67±0．93）ng／ml，较血浆置换前血清HMGB1水平（7．8±1．26）ng／ml显著下降，血浆置换后12 h血清HMGB1水平（5．18±0．93）ng／ml稍有回升，但仍低于血浆置换前浓度（ P<0．05）；血管炎活动指标（ESR、CRP、BVAS评分）较血浆置换前均降低。结论：血浆置换能有效清除AASV患者外周血清HMGB1，可明显降低疾病活动度。
目的：觀察血漿置換對抗中性粒細胞胞質抗體相關性血管炎（ ANCA-associated vasculitis，AAV）外週血高遷移率族蛋白-1（highmobility group box chromosomal protein 1，HMGB1）的影響。方法：13例活動期 AAV患者，男10例，女3例，年齡41歲～76歲，BVAS評分（21．8±4．9）分，其中11例p／MPO-ANCA暘性，2例c／PR3-ANCA暘性，ANCA水平（295．78±52．76）RU／mL。均給予糖皮質激素及其遲擊療法等治療基礎上，輔以血漿置換。分彆留取血漿置換治療前空腹（TO）、治療開始後2 h（T1）、血漿置換停止後12 h（T2）患者靜脈血標本，分離血清後採用ELISA法檢測其中的HMGB1。結果：本組患者行血漿置換後2 h血清HMGB1水平（3．67±0．93）ng／ml，較血漿置換前血清HMGB1水平（7．8±1．26）ng／ml顯著下降，血漿置換後12 h血清HMGB1水平（5．18±0．93）ng／ml稍有迴升，但仍低于血漿置換前濃度（ P<0．05）；血管炎活動指標（ESR、CRP、BVAS評分）較血漿置換前均降低。結論：血漿置換能有效清除AASV患者外週血清HMGB1，可明顯降低疾病活動度。
목적：관찰혈장치환대항중성립세포포질항체상관성혈관염（ ANCA-associated vasculitis，AAV）외주혈고천이솔족단백-1（highmobility group box chromosomal protein 1，HMGB1）적영향。방법：13례활동기 AAV환자，남10례，녀3례，년령41세～76세，BVAS평분（21．8±4．9）분，기중11례p／MPO-ANCA양성，2례c／PR3-ANCA양성，ANCA수평（295．78±52．76）RU／mL。균급여당피질격소급기충격요법등치료기출상，보이혈장치환。분별류취혈장치환치료전공복（TO）、치료개시후2 h（T1）、혈장치환정지후12 h（T2）환자정맥혈표본，분리혈청후채용ELISA법검측기중적HMGB1。결과：본조환자행혈장치환후2 h혈청HMGB1수평（3．67±0．93）ng／ml，교혈장치환전혈청HMGB1수평（7．8±1．26）ng／ml현저하강，혈장치환후12 h혈청HMGB1수평（5．18±0．93）ng／ml초유회승，단잉저우혈장치환전농도（ P<0．05）；혈관염활동지표（ESR、CRP、BVAS평분）교혈장치환전균강저。결론：혈장치환능유효청제AASV환자외주혈청HMGB1，가명현강저질병활동도。
Objective:To investigate the effects of plasmapheresis on serum HMGBl level in patients with ANCA-associat-ed vasculitis(AAV). Methods:13 patients with ANCA-associated vasculitis(female 3,male10,age 41~76 years)with new onset and active AAV were admitted to Department of Nephropathy of The First Hospital of Quanzhou Affiliated to Fujian Medical Universi-ty. BVAS scores were(21. 8 ± 4. 9). 11 patients had serum positive P/MPO-ANCA,the others had serum positive C/PR3-AN-CA,and the average levels of ANCA were(295. 78 ± 52. 76)RU/ml. These patients were treated with glucocorticoid and corticoste-roid,on basis of which plasma exchange therapy was performed. Blood samples for determination of HMGB1 concentrations from 13 patients were collected before plasmuplercsis,during(2 hours after initiation)and 12 hours after plasmapheresis. The plasma levels of HMGB1 were determined by enzyme-linked immunosorbent assay. Results:Concentrations of HMGB1 of patients before plasmaph-eresis averaged(7. 8 ± 1. 26)ng/ml,(3. 67 ± 0. 93)ng/ml 2 hours after the initiation and slightly rose to(5. 18 ± 0. 93)ng/ml 12 hours after the treatment(P<0. 05). And the activity index of the disease(ESR、CRP、BVAS score)significantly declined. Conclu-sion:Plasmapheresis treatment significantly reduced serum levels of HMGB1 and controlled the condition of patients with AAV.
