DNA免疫吸附治疗对狼疮性肺炎患者肺功能与血清免疫球蛋白及Th1/Th2细胞因子失衡影响

Effects of DNA Immunosorbent Therapy on Pulmonary Function and Imbalance of Serum Immunoglobulin and Th1/Th2 Cytokines in Patients with Lupus Pneumonia

目的:分析DNA免疫吸附治疗对狼疮性肺炎患者肺功能与血清免疫球蛋白及Th1/Th2细胞因子失衡影响。方法:前瞻性选取2015年1月-2017年6月间在本院接受治疗的狼疮间质性肺炎患者150例,依据随机数字表法将其分成两组,对照组(75例)患者缓释性抗风湿剂(DMARD)结合血液净化治疗,观察组(75例)患者在对照组基础上进行DNA免疫吸附治疗;观察患者临床治疗效果、不良反应如恶心、呕吐、皮疹和血小板降低及狼疮活动度状况。结果:观察组患者总有效率为93.33%,高于对照组的76.00%,差异有统计学意义(P<0.05);观察组治疗后的系统性红斑狼疮活动度(SLEDAI)评分、IgG、IgM及IgA含量与治疗前相比均降低,差异有统计学意义(P<0.05);观察组治疗后与对照组治疗后的SLEDAI评分、IgG、IgM及IgA含量相比均降低,差异有统计学意义(P<0.05);观察组治疗后的最大通气量(MVV)、用力肺活量(FVC)和第1秒用力呼吸量/FVC(FEV1/FVC)与治疗前相比均升高,差异有统计学意义(P<0.05);观察组治疗后与对照组治疗后的MVV、FEV1/FVC、FCV相比均升高,差异有统计学意义(P<0.05);观察组治疗后的Th1及Th1/Th2与治疗前相比均升高,Th2降低,差异有统计学意义(P<0.05);观察组治疗后与对照组治疗后的Th1及Th1/Th2相比均升高,Th2降低,差异有统计学意义(P<0.05);两组不良反应发生率比较差异无统计学意义(χ^2=0.894,P=0.341)。结论:DNA免疫吸附治疗可显著改善狼疮间质性肺炎患者肺功能,降低免疫球蛋白含量,且安全性较高。

Objective:To analyze the effects of DNA immunosorbent therapy on pulmonary function and imbalance of serum immunoglobulin and Th1/Th2 cytokines in patients with lupus pneumonia.Methods:Prospectively selecting 150 cases of patients with lupus interstitial pneumonia from January 2015 to June 2017 in our hospital and patients were divided into two groups, control group(75 cases) patients with slow-releasing potential anti-rheumatism agent(DMARD) combined with blood purification treatment and observation group(75 cases) patients in the control group on the basis of DNA immunoadsorption therapy, according to random number table method;the clinical effects, adverse reactions such as nausea, vomiting, skin rash and thrombocytopenia, and lupus activity were observed.Results:The total effective rate of the observation group was 93.33%,higher than that of the control group(76.00%),and the difference was statistically significant(P<0.05);the SLEDAI score,IgG,IgM and IgA levels of the observation group were significantly lower than those before treatment(P<0.05).SLEDAI score,IgG,IgM and IgA levels of the observation group and the control group all decreased after treatment,and the difference was statistically significant(P<0.05);the MVV,FVC and FVC of the observation group were all increased after treatment, and the difference was statistically significant(P<0.05).MVV,FEV1/FVC and FCV of the observation group increased after treatment compared with the control group,and the difference was statistically significant(P<0.05);after treatment, Th1 and Th1/Th2 in the observation group were both increased and decreased compared with that before treatment, and the difference was statistically significant(P<0.05).After treatment,Th1 and Th1/Th2 in the observation group were both increased and decreased compared with the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^2=0.894,P=0.341).Conclusion:DNA immunosorbent therapy enable to improve the pulmonary function of patients with lupus interstitial pneumonia, reduce the content of immunoglobulin significantly, and safety is high.