血浆置换疗法对大疱性类天疱疮患者临床疗效及血清自身抗体的影响

Effect of Plasma Exchange Therapy on Clinical Efficacy and Serum Autoantibodies in Patients with Bullous Pemphigoid

目的探讨血浆置换疗法在大疱性类天疱疮患者中的应用效果及对其血清自身抗体的影响.方法选取2020年1月—2022年1月我院收治的大疱性类天疱疮患者70例,按随机数字表法分为两组,每组35例.对照组采用常规治疗,观察组在此基础上采用血浆置换疗法,均治疗2周.比较两组的临床疗效、炎症水平、血清自身抗体水平、生活质量及不良反应发生情况.结果观察组的治疗总有效率为94.29%,高于对照组的77.14%,差异有统计学意义(P<0.05).治疗后,观察组的白细胞介素-6、白细胞介素-8及肿瘤坏死因子-α水平分别为(89.14±7.12)μg/L、(182.34±15.58)μg/L、(68.52±6.17)μg/L,均低于对照组的(96.58±7.25)μg/L、(201.46±16.12)μg/L、(75.41±6.25)μg/L,组间差异有统计学意义(P<0.05).治疗后,观察组的抗BP180抗体、免疫球蛋白G1、免疫球蛋白G4水平分别为(47.56±4.12)U/mL、(0.28±0.05)U/mL、(0.15±0.02)U/mL,均低于对照组的(52.63±4.89)U/mL、(0.37±0.08)U/mL、(0.22±0.04)U/mL,组间差异有统计学意义(P<0.05).治疗后,观察组的生理、心理、社会及环境领域评分分别为(87.52±6.29)分、(88.41±6.35)分、(90.42±4.39)分、(92.25±3.21)分,均高于对照组的(81.14±6.25)分、(82.68±6.27)分、(85.12±5.22)分、(86.63±4.17)分,组间差异有统计学意义(P<0.05).两组的不良反应发生率比较,差异无统计学意义(P>0.05).结论血浆置换疗法可提高大疱性类天疱疮患者的治疗效果,降低其自身抗体水平,减轻炎症反应,改善生活质量,安全可靠.

Objective To investigate the effect of plasma exchange therapy on clinical efficacy and serum autoantibodies in patients with bullous pemphigoid.Methods 70 patients with bullous pemphigoid admitted to our hospital from January 2020 to January 2022 were selected and were divided into two groups according to random number table method,with 35 cases in each group.The control group received conventional treatment,and the observation group received plasma exchange therapy on this basis.Both groups were treated for 2 weeks.The clinical efficacy,inflammatory levels,serum autoantibody levels,quality of life and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 94.29%,higher than 77.14%of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of interleukin-6,interleukin-8 and tumor necrosis factor-αin the observation group were(89.14±7.12)μg/L,(182.34±15.58)μg/L,and(68.52±6.17)μg/L,respectively,which were lower than(96.58±7.25)μg/L,(201.46±16.12)μg/L,(75.41±6.25)μg/L in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the levels of anti-BP180 antibody,immunoglobulin G1 and immunoglobulin G4 in the observation group were(47.56±4.12)U/mL,(0.28±0.05)U/mL and(0.15±0.02)U/mL,respectively,which were lower than(52.63±4.89)U/mL,(0.37±0.08)U/mL and(0.22±0.04)U/mL in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the scores of physiological,psychological,social and environmental fields in the observation group were(87.52±6.29)points,(88.41±6.35)points,(90.42±4.39)points,(92.25±3.21)points,respectively,which were higher than(81.14±6.25)points,(82.68±6.27)points,(85.12±5.22)points and(86.63±4.17)points in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Plasma exchange therapy can improve the therapeutic effect of bullous pemphigoid patients,reduce the level of autoantibody and inflammatory response,improve quality of life,which is safe and reliable.