强化免疫干预联合血液透析对狼疮性肾炎尿毒症的临床疗效分析

Clinical efficacy of enhanced immune intervention combined with hemodialysis in uremia of lupus nephritis

目的探讨强化免疫干预联合血液透析对狼疮性肾炎尿毒症的临床疗效。方法选取2014年10月～2016年10月期间于本院住院治疗的狼疮性肾炎尿毒症患者60例为研究对象。采用随机数字分组法将其分为对照组和观察组,各30例。观察组采用血液透析+甲基强的松龙+环磷酰胺治疗,对照组血液透析+甲基强的松龙治疗。比较两组患者治疗前后Scr、C4、CH50、ESR水平变化情况及临床疗效。结果两组患者治疗前Scr、C4、CH50、ESR水平比较差异无统计学意义,治疗后Scr、ESR水平均显著降低,C4、CH50水平均显著升高(P<0.05);观察组治疗后Scr、ESR水平均显著低于对照组,C4水平显著高于对照组(P<0.05)。观察组显效22例(73.33%)、总有效29例(96.67%),对照组显效13例(43.33%)、总有效23例(76.67%),观察组显效率及总有效率均明显高于对照组(P<0.05)。结论强化免疫干预联合血液透析可显著改善狼疮性肾炎尿毒症患者血清Scr、C4、CH50、ESR等实验室指标水平,临床疗效显著,值得推广应用。

Objective To investigate the clinical effect of intensive immunization and hemodialysis on uremia of lupus nephritis.Methods 60 cases of lupus nephritis with uremia in our hospital during the period of October 2014-October 2016 were selected as the subjects.It was divided into the control group and the observation group by the random digital grouping method,each with 30 cases.The observation group was treated with hemodialysis+methylprednisolone+cyclophosphamide,and the control group was treated with hemodialysis plus methylprednisolone.The changes of Scr,C4,CH50 and ESR were compared and the clinical effects were compared between the two groups before and after treatment.Results Two groups of patients before treatment,Scr,C4,CH50 and ESR levels had no significant difference,Scr after treatment,ESR levels were significantly decreased,C4 and CH50 levels were significantly increased(P<0.05);the observation group after treatment Scr,ESR levels were significantly lower than the control group,the level of C4 was significantly higher than that of the control group(P<0.05).In the observation group,22 cases(73.33%)were markedly effective,29 cases(96.67%)were total effective,13 cases(43.33%)were markedly effective in the control group,23 cases(76.67%)were total effective,and the effective rate and the total effective rate in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Enhanced immune intervention combined with hemodialysis can significantly improve the serum Scr,C4,CH50 and ESR levels in patients with lupus nephritis,and has significant clinical efficacy,which is worthy of popularization and application.