血液灌流治疗原发性干燥综合征的疗效观察

Effect of Hemoperfusion in the Treatment of Primary Sjogren′s Syndrome

目的观察血液灌流对原发性干燥综合征(pSS)患者的临床疗效。方法选取2012-02-25—06-30在我院风湿免疫科住院的13例pSS活动期患者,均行锁骨下深静脉置管后,采用肝素抗凝,进行血液灌流治疗,每次灌流时间为2～3 h,1～2次/周,共灌流3次。检测并比较患者血液灌流前后的红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)和外周血CD3+、CD4+、CD8+T细胞百分比及CD4+/CD8+。结果血液灌流后,pSS患者ESR、RF、IgG、IgA及外周血CD4+T淋巴细胞百分比、CD4+/CD8+较血液灌流前降低,CD3+、CD8+T淋巴细胞百分比较血液灌流前升高,差异有统计学意义(P<0.05)。血液灌流后,10例患者口干症状减轻,9例患者关节痛明显改善,7例患者眼干减轻。结论血液灌流能缓解pSS患者的临床症状,改善实验室检查指标。

Objective To investigate the clinical effect of hemoperfusion in treating patients with primary Sjogren＇s syndrome （pSS） . Methods A total of 13 patients with active pSS in rheumatology department of our hospital between 2012 -02 - 25 and 06 - 30 were selected. After subclavian vein catheterization, heparin anticoagulation and hemoperfusion treatment were adopted, 2 ~ 3 h perfusion time at a time, 1 ~ 2 times once a week, and 3 times perfusion in all. Laboratory indexes were detec- ted and compared, such as erythrocyte sedimentation rate （ESR）, C -reactive protein （ CRP）, rheumatoid factor （RF）, im- munoglobulin G （IgG）, immunoglobulin A （IgA）, immunoglobulin M （IgM）, peripheral blood CD3＋, CD4 ＋, CD8 ＋ T lymphocytes percentage and CD4＋/CD8＋ Results Compared with pre - hemoperfusion, the level of plasma ESR, RF, IgG, IgA and peripheral blood percentage of CD4 ＋ T lymphocytes and CD4＋/CD8＋ lymphocytes decreased, and the percentage of CD3＋ , CD8＋ T lymphoeytes in peripheral blood were improved significantly after hemoperfusion （ P 〈 0. 05 ） . After hemoperfu- sion treatment, the clinical symptoms of the pSS patients were improved remarkably, including 10 patients with relief of dry mouth symptom, 9 patients with significant improvement in joint pain and 7 patients with relief of dry eyes symptom. Conclusion Hemoperfusion can relieve clinical symptoms in patients with pSS and improve laboratory indexes.