连续性静脉-静脉血液滤过联合霉酚酸酯治疗狼疮性肾炎患者临床研究

Clinical Study of Continuous Veno Venous Hemofiltration Combined with Mycophenolate Mofetil in the Treatment of Lupus Nephritis

目的研究连续性静脉-静脉血液滤过联合霉酚酸酯治疗狼疮性肾炎患者临床疗效。方法选取平顶山市第一人民医院2015年1月~2016年12月狼疮性肾炎患者42例,按治疗方案不同分组,各21例。对照组予以霉酚酸酯+泼尼松治疗,观察组予以连续性静脉-静脉血液滤过+霉酚酸酯治疗。比较两组治疗效果、治疗前后系统性红斑狼疮疾病活动度评分(SLEDAI)、24h尿蛋白定量、血肌酐及不良反应发生情况。结果观察组总缓解率95.24%高于对照组61.90%,差异有统计学意义(P<0.05);治疗前两组SLEDAI评分、尿蛋白定量、血肌酐比较,差异无统计学意义(P>0.05);治疗2个月、4个月、6个月后观察组SLEDAI评分、尿蛋白定量、血肌酐低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率9.31%低于对照组27.91%,差异有统计学意义(P<0.05)。结论连续性静脉-静脉血液滤过联合霉酚酸酯治疗狼疮性肾炎患者效果显著,可有效抑制疾病活动,降低不良反应发生率。

Objective To study the clinical efficacy of continuous veno venous hemofiltration combined with mycophenolate mofetil in the treatment of lupus nephritis.Methods 42 cases of lupus nephritis in the first people＇s Hospital of Pingdingshan from January 2015 to December 2016 were divided into groups according to the treatment plan,each with 21 cases.The control group was treated with mycophenolate mofetil combined with prednisone,and the observation group was treated with continuous veno venous hemofiltration combined with mycophenolate mofetil.The curative effect,the degree of disease activity（SLEDAI）before and after the treatment and 24 hurinary protein quantification,serum creatinine,the occurrence of adverse reactions were compared..Results The total remission rate of the observation group was 95.24%,higher than that of the control group（61.90%）,and the difference was statistically significant（P〈0.05）.The SLEDAI scores,urinary protein quantification,serum creatinine of the two groups before the treatment were not statistically significant（P〈0.05）.After treatment for 2 months,4 months and 6 months,the SLEDAI score,urinary protein quantification and serum creatinine in the observation group was lower than that in the control group（P〈0.05）.The difference was statistically significant（P〈0.05）.The incidence of adverse reactions was 9.31%in the observation group and 27.91%in the control group.The difference was statistically significant（P〈0.05）.ConclusionContinuous veno venous hemofiltration combined with mycophenolate mofetil is effective in the treatment of lupus nephritis.It can effectively inhibit disease activity and reduce the incidence of adverse reactions.