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目的 探讨自身骨髓移植（ＡＢＭＴ）治疗系统性红斑狼疮（ＳＬＥ）的临床效果。方法 选迁延不愈的ＳＬＥ患者３例，硬膜外麻醉下，在髂后上棘取骨髓造血干细胞，４℃保存。预处理方案：２例为环磷酸胺１２０ｍｇ／ｋｇ，马法兰１４０ｍｇ／ｍ２；１例为环磷酸胺１２０ｍｇ／ｋｇ加ＶＰ－１６１．０ ｇ／ｍ２。预处理后回输骨髓造血干细胞。粒细胞刺激因子（Ｇ－ＣＳＦ）协助造血及免疫重建。结果 移植后３例患者临床症状均缓解，２例免疫球蛋白降低１０ｇ／Ｌ左右，补体升高，自身抗体大部分转阴。例２皮肤病理显示原有的组织损伤减轻或消失，心肌肥厚及心包积液消失。例３移植后２周心磷脂抗体转阴，２４ｈ尿蛋白定量移植前８．５０ｇ，移植３个月后减少至２．４３ｇ。结论（ｌ）ＡＢＭＴ治疗ＳＬＥ近期疗效显著。（２）疗效机制可能与预处理后组织中免疫病理细胞的减少，免疫球蛋白降低，自身抗体量的下降有关。
Objective To investigate the clinical effect of autologous bone marrow transplantation (ABMT) in the treatment of systemic lupus erythematosus (SLE). Methods Three cases of SLE patients with delayed healing were selected. Under epidural anesthesia, bone marrow hematopoietic stem cells were collected from posterior superior iliac spine and preserved at 4 ℃. Pretreatment program: 2 cases of cyclophosphamide 120mg / kg, melphalan 140mg / m2; 1 case of cyclophosphamide 120mg / kg plus VP-161.0 g / m2. After pretreatment, bone marrow hematopoietic stem cells were transfused. Granulocyte-stimulating factor (G-CSF) assists in hematopoietic and immune reconstitution. Results The clinical symptoms of 3 patients were relieved after transplantation. The immunoglobulin in 2 cases was reduced by about 10 g / L, the complement was increased and most of the autoantibodies turned negative. Example 2 skin pathology showed that the original tissue damage reduced or disappeared, myocardial hypertrophy and pericardial effusion disappeared. Example 3 2 weeks after transplantation cardiolipin antibody negative, 24h urine protein before quantitative transplantation 8.50g, 3 months after transplantation reduced to 2.43g. Conclusion (1) ABMT treatment of SLE significant effect. (2) The therapeutic mechanism may be related to the reduction of immunopathological cells, immunoglobulins and the decrease of autoantibodies in pretreatment tissues.