DNA免疫吸附治疗重症系统性红斑狼疮的临床观察

Therapeutic effects of DNA immunoadsorption therapy on severe systemic lupus erythematosus

目的:探讨DNA免疫吸附治疗重症系统性红斑狼疮(SLE)的临床有效性、安全性。方法:收集重症SLE患者20例,分为观察组(8例)和对照组(12例)。观察组采用连续性血液净化联合DNA免疫吸附配合泼尼松片、环磷酰胺治疗,对照组采用甲强龙冲击后,给予泼尼松片联合环磷酰胺治疗。比较2组患者治疗前及治疗12周、24周SLEDAI评分及ANA、抗ds-DNA抗体滴度,Ig G,Ig A,Ig M,C3,C4,肾功能等指标。结果:与对照组比较,治疗12周观察组SLEDAI评分、ANA与抗ds-DNA抗体滴度下降更快(P均<0.05),24周时观察组ANA滴度仍能维持在较低水平(P均<0.05)。治疗24周,2组患者肾功能均稳定。观察组除1例发生重症感染,无精神异常、心律失常等不良反应发生。结论:DNA免疫吸附治疗重症SLE安全、有效。

Aim： To investigate the clinical efficacy and safety of DNA immunoadsorption on patients with severe systemic lupus erythematosus（ SLE）.Methods： Twenty cases of severe SLE were allocated into 2 groups; observation group（ n = 8） received continuous blood purification,DNA immunoadsorption and glucocorticoid treatment,and control group（ n = 12） received cyclophosphamide combined with glucocorticoid treatment.Before and at 12 and 24 weeks after the therapy,SLEDAI score,autoantibodies（ ANA） and anti-ds DNA autoantibody titer,Ig G,Ig A,Ig M levels,C3 and C4 and renal function parameters were assessed.Results： At 12 weeks after the treatment,the SLEDAI score,ANA and anti-ds DNA autoantibody titer in the observation group decreased more significantly than control group; at 24 weeks after the treatment,the ANA titer in the observation group still maintained in a low level（ P〈 0.05）.The renal function were stable in two groups during 24 weeks.There were no obvious side effects except for a case of severe infection.Conclusion： DNA immunoadsorption in treatment of severe SLE is effective and safe.