淋巴血浆置换术治疗儿童系统性红斑狼疮重度活动合并感染者6例的短期疗效分析

Analysis on the short-term efficacy of lymphoplasmapheresis in treatment of 6 cases of severely active systemic lupus erythematosus complicated with infections in children

目的分析淋巴血浆置换术(LPE)治疗儿童系统性红斑狼疮(SLE)重度活动合并感染者6例的短期疗效。方法分析广西壮族自治区人民医院2021年1月至2024年1月收治的6例SLE重度活动合并感染患儿的临床资料,在传统药物治疗的基础上采用LPE治疗,观察临床效果及不良反应发生情况。结果与LPE治疗前比较,LPE治疗后6例SLE患儿外周血白细胞计数、淋巴细胞计数均变化不大,血小板计数、B细胞计数、NK细胞计数、抗双链DNA抗体水平、抗核抗体滴度、免疫球蛋白G(IgG)水平、24 h尿蛋白定量及尿红细胞计数均有不同程度下降,补体C3水平显著上升。除1例血红蛋白含量升高外,其他5例血红蛋白含量均下降,6例SLE患儿均未观察到有重要器官受累加重情况,所受累器官均在后续治疗中逐步改善,均无不良反应发生。结论在传统药物治疗的基础上采用LPE治疗儿童SLE重度活动合并感染,短期内可获得良好临床效果。

Objective To analyze the short-term efficacy of lymphoplasmapheresis(LPE)in treatment of 6 cases of severely active systemic lupus erythematosus(SLE)complicated with infections in children.Methods The clinical data of 6 pediatric patients with severely active SLE complicated with infections who were treated in the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2021 to January 2024 were analyzed.On the basis of traditional drug therapy,the 6 pediatric patients were treated with LPE,and their clinical therapeutic effect and the occurrence of adverse reactions were observed.Results Compared with those before LPE treatment,peripheral blood leukocyte count and lymphocyte count did not change much,and platelet count,B cell count,natural killer(NK)cell count,anti-double-stranded deoxyribonucleic acid(DNA)antibodies level,anti-nuclear antibodies titer and immunoglobulin G(IgG)level,24-hour urine protein quantitation and urinary red blood cell count all decreased to varying degrees,and the complement C3 increased significantly in the 6 pediatric patients after LPE treatment,and the content of hemoglobin decreased in 5 cases but increased in 1 case.No aggravation of vital organ involvement was observed in all the 6 pediatric patients,and all the affected organs gradually improved during the subsequent treatment.No adverse reactions occurred in all the 6 pediatric patients during LPE treatment.Conclusion On the basis of traditional drug therapy,LPE treatment can obtain good clinical effect on severely active SLE complicated with infections in children in a short time.