PH-350免疫吸附技术联合免疫抑制剂治疗狼疮性肾炎临床疗效观察

Clinical efficacy of immunoadsorption combined with immune inhibitors in the treatment of lupus nephritis

目的探讨苯丙氨酸(PH-350)免疫吸附治疗狼疮性肾炎(LN)的效果及临床应用价值。方法收集狼疮性肾炎患者106例,随机分为治疗组(51例)和对照组(55例),治疗组运用PH-350免疫吸附配合激素和免疫抑制剂治疗,对照组予激素和免疫抑制剂治疗。比较两组患者治疗前后SLEDAI评分及24h尿蛋白定量、抗双链DNA抗体(ds-DNA)定量、抗核小体抗体(NUCL)定量、免疫球蛋白、补体C3、C4、血沉(ESR)、C反应蛋白(CRP)、血红蛋白(Hb)、电解质、肾功能、肝功能等指标并行统计学分析。结果接受免疫吸附治疗后(2周、4周、12周、24周)的患者,其血沉、CRP、免疫球蛋白、抗ds-DNA抗体定量、NUCL定量、SLEDAI评分与对照组患者比较明显下降,差异均具有统计学意义(P<0.05);4周时Hb上升(P<0.05);12周时24h尿蛋白明显下降(P<0.05),其他各项生化指标无明显改变,无肝肾功能损害(P>0.05),临床症状更快缓解(P<0.05);24周复发率较低(P<0.05)。结论免疫吸附治疗狼疮性肾炎起效更迅速、疗效较显著,且安全无明显副反应,复发率低。

Objective To explore the efficacy and clinical application of phenylalanine immunosorbent assay（PH-350） in the treatment of lupus nephritis（LN）.Methods One hundred and six patients with LN were randomly divided into the study group（n=51） and the control group（n=55）.The treatment group was treated by PH-350 immunosorbent combined with hormone and immune inhibitors.The control group was treated by hormone and immune inhibitors.Indexes were compared between the two groups before and after treatment,including SLEDAI score,24-hour urine protein,anti-dsDNA antibodies,anti-nucleosome antibodies（AnuA）,immunoglobulin,complement C3,C4,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,hemoglobin（Hb）,electrolytes,kidney function,liver function.Results After treatment（2 weeks,4 weeks,12 weeks,24 weeks）,the ESR,CRP,immunoglobulin,quantification of anti-dsDNA antibodies,quantification of NUCL,SLEDAI score were declined significantly in the study group,compared with the control group（P0.05）.The levels of Hb increased in the fourth week,and the levels of 24-hour urine protein were significantly decreased in the 12th week（P0.05）,with no significant change in liver and kidney function and other biochemical indexes（P0.05）.The clinical symptoms showed faster alleviation（P 0.05）,and the recurrence rate was lower in the 24th week（P0.05）.Conclusion The immunoadsorption treatment is quite effective and safe for treating lupus nephritis,without obvious side effects,and the recurrence rate is low.