江西医药2019年10月第54卷第10期JiangxiMedicalJournal袁October2019袁Vol54袁No10CRRT联合免疫吸附对重症系统性红斑狼疮患者免疫功能调节的影响*
叶兴文，李雪飞，尹海琴，余跃石峰，杨蕙文，罗余生，喻秋平，
(九江学院附属医院风湿免疫科、重症医学科，九江332000)
论著窑窑
1167窑窑
摘要：目的观察CRRT联合免疫吸附对重症系统性红斑狼疮患者免疫调节影响遥方法将31例重症SLE患者分为对照组尧IA组及CRRT+IA组遥所有患者入院后均按指南要求给予糖皮质激素和免疫抑制剂药物治疗遥IA组采用在此基础上给予DNA免疫吸附治疗袁CRRT+IA组在IA组基础上联合CRRT渊连续性静-静脉血液滤过模式CVVH冤治疗遥疗程为收住风湿免疫科渊重症监护病房冤后连续3d遥抽取治疗前和治疗后第3尧7d静脉血袁检测血清干扰素渊INF冤-琢尧白介素渊IL冤-6尧IL-10浓度曰抗核小体抗体尧抗双链DNA渊dsDNA冤抗体水平以及免疫球蛋白IgG尧IgA尧IgM尧血清补体C3尧C4水平遥结果治疗后3组患者的细胞因子浓度尧特异性自身抗体尧免疫球蛋白及补体水平等指标均较前有所好转遥IA组抗核小体抗体尧抗双链DNA渊dsDNA冤抗体尧免疫球蛋白IgG水平下降显著渊P约0.05冤曰CRRT+IA组较IA组血清干扰素渊INF冤-琢尧白介素渊IL冤-6尧IL-10浓度下降显著渊P约0.05冤袁治疗7天后免疫球蛋白IgA尧IgM水平下降显著渊P约0.05冤尧血清补体C3尧C4水平增高明显渊P约0.05冤遥结论对于重症系统性红斑狼疮患者袁在传统的药物治疗基础上早期应用CRRT联合DNA免疫吸附这种集成血液净化模式治疗袁能显著改善患者免疫紊乱状态袁调节免疫功能袁缓解及控制疾病进展遥
关键词:CRRT曰免疫吸附曰重症系统性红斑狼疮曰免疫调节中图分类号：R593.241
文献标识码：B
文章编号：1006-2238(2019)10-1167-04
DOI院10.3969/j.issn.1006-2238.2019.10.007
InvestigationoneffectofCRRTcombinedwithimmuneadsorptiononimmuneregulationinpatientswithseveresystemiclupuserythematosusSHIFeng,YANGHuiwen,LUOYusheng,etal.DepartmentofRheumatologyandImmunology,CriticalCareMedicine,AffiliatedHospitalofJiujiangUniversity,Jiujiang332000,China.
severesystemiclupuserythematosus.Methods31patientswithsevereSLEweredividedintocontrolgroup,IAgroupandCRRT+IAgroup.Allpatientsweretreatedwithglucocorticoidandimmunosuppressivedrugsaccordingtotheguidelinesafteradmission.GroupIAwastreatedwithDNAimmunosorbenttherapyonthisbasis.TheCRRT+IAgroupwastreatedwithCRRT(continuousmissiontothedepartmentofrheumatologyandimmunology(icu).Venousbloodwasextractedbeforetreatmentandatday3and7aftertreatment,andserumconcentrationsofIFN-琢,interleukin-6andil-10weredetected曰Anti-nucleosomeantibody,anti-dou鄄treatment,cytokineconcentrations,specificautoantibodies,immunoglobulinandcomplementlevels,andSLEactivityindexscorevenovenoushemofiltrationmodeCVVH)onthebasisoftheIAgroup.Thecourseoftreatmentwasfor3consecutivedaysafterad鄄
Abstract院ObjectiveToobservetheeffectofCRRTcombinedwithimmuneadsorptiononimmuneregulationinpatientswith
blestrandedDNA(dsDNA)antibodylevels,andimmunoglobulinIgG,IgA,IgM,serumcomplementC3,C4levels.ResultsAfter(SLEDAI)andotherindicatorsinthethreegroupswerebetterthanbefore.Thelevelofanti-nucleosomeantibody,anti-doublestrandedDNA(dsDNA)antibodyandimmunoglobulinIgGingroupIAdecreasedsignificantly(P<0.05).Theserumlevelsofinter鄄feronIFN-琢,interleukin-6andil-10intheCRRT+IAgroupweresignificantlylowerthanthoseintheIAgroup(P<0.05).7daysnificantly(P<0.05).ConclusionForpatientswithseveresystemiclupuserythematosus,earlyapplicationofthemulti-bloodpu鄄
Keywords:CRRT;Immunosorption;Severesystemiclupuserythematosus;Immuneregulation.
aftertreatment,IgAandIgMlevelsofimmunoglobulindecreasedsignificantly(P<0.05).SerumlevelsofC3andC4increasedsig鄄rificationmodeofCRRTcombinedwithDNAimmunosorptiononthebasisoftraditionaldrugtherapycansignificantlyimprovetheimmunedisorderstatusofpatients,regulatetheimmunefunction,alleviateandcontrolthediseaseprogression.
渊Systemiclupus
erythematosus袁SLE冤是一种自身免疫介导的尧以免疫性炎症为突出表现的尧累及多系统的弥漫性结
编号20197196*基金项目：江西卫生健康委科技计划项目，
系统性红斑狼疮
以及生物制剂的出现极大地改善了SLE患者的预后袁但一些重症SLE患者袁尤其是合并狼疮危象进展患者袁由于病情进展迅速袁常规的药物治疗反应
缔组织病[1]遥尽管糖皮质激素和免疫抑制剂的使用
CRRT联合免疫吸附对重症系统性红斑狼疮患者免疫功能调节的影响 - 论文
