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目的探讨免疫吸附治疗狼疮性肾炎的临床疗效。方法在应用免疫抑制剂的基础上,使用DNA免疫吸附柱,血流量150～200ml/min,时间2h。观察单次免疫吸附治疗3d后抗核抗体(ANA)、抗双链DNA抗体(ds-DNA)、血常规、尿常规、肝功能、肾功能、血离子、免疫球蛋白及补体的变化情况,同时观察临床表现和不良反应。结果 17例患者插入免疫吸附治疗后6～12周病情缓解,血肌酐、尿素氮、尿蛋白定量水平明显下降,血白蛋白水平回升。部分患者抗核抗体(ANA)及双链DNA转阴,转阴率为70%。结论免疫吸附柱能有效清除血中循环免疫复合物含量,降低IgG等免疫球蛋白水平,与中小剂量激素及免疫抑制剂联用,能迅速缓解活动性狼疮性肾炎的病症,改善肾功能。
Objective To investigate the clinical effect of immunosuppression in the treatment of lupus nephritis. Methods Based on the application of immunosuppressive agents, DNA immunosorbent column was used. Blood flow was 150 ~ 200ml / min and time was 2h. To observe the changes of anti-nuclear antibody (ANA), anti-double-stranded DNA antibody (ds-DNA), blood, urine, liver function, renal function, blood ion, immunoglobulin and complement after single immunosorbent treatment for 3 days, At the same time observe the clinical manifestations and adverse reactions. Results Seventeen patients were relieved after 6-12 weeks of immunosuppressive therapy. The levels of serum creatinine, blood urea nitrogen, and urine protein were significantly decreased, and serum albumin levels rose. Some patients anti-nuclear antibody (ANA) and double-stranded DNA negative, negative conversion rate was 70%. Conclusions Immunoadsorption column can effectively remove circulating immunocomplex in blood and reduce the level of IgG and other immunoglobulins. Combined with small and medium-dose hormones and immunosuppressive agents, the immunosorbent column can quickly relieve the symptoms of active lupus nephritis and improve renal function.