蛋白A免疫吸附和DNA230免疫吸附治疗狼疮肾炎疗效比较

Comparison of protein A immunosorbent and DNA 230 immunosorbent in the treatment of lupus nephritis

目的观察蛋白A免疫吸附、DNA230免疫吸附治疗狼疮肾炎的疗效及对免疫功能的影响。方法选取2017年1月-2018年6月空军军医大学第一附属医院临床免疫科收治的狼疮肾炎患者60例,采用随机数字表法分为2组各30例。观察组接受蛋白A免疫吸附治疗,对照组给予DNA230免疫吸附治疗。治疗8周后比较2组治疗总有效率,治疗前后肾功能、尿蛋白定量及血清免疫球蛋白IgA IgM、IgG水平、狼疮活动积分(SLEDAI),并观察不良反应。结果观察组治疗总有效率为96.7%,明显高于对照组的86.7%(χ^2=3.893,P=0.045)。治疗后观察组IgM、IgA、IgG均低于对照组(t/P=6.923/0.000、9.259/0.000、9.025/<0.001),而SLEDAI评分差异无统计学意义(t=0.262,P=0.794)。2组患者血肌酐、尿素氮以及尿蛋白定量下降显著,但2组比较差异无统计学意义(P>0.05)。结论蛋白A免疫吸附对狼疮肾炎疗效较传统DNA免疫吸附好,可明显改善患者免疫功能,具备临床推广使用价值。

Objective To observe the effect of protein A immunosorbent and DNA 230 immunosorbent on lupus nephritis and its influence on immune function.Methods Sixty patients with lupus nephritis were selected from the Department of Clinical Immunology,First Affiliated Hospital of Air Force Military Medical University from January 2017 to June 2018.They were divided into two groups with 30 cases in each group by a random number table.The observation group received protein A immunosorbent therapy,while the control group received DNA 230 immunosorbent therapy.After 8 weeks of treatment,the total effective rate was compared between the two groups.The renal function,urinary protein quantification,serum immunoglobulin IgA,IgM,IgG levels,lupus activity score(SLEDAI)and adverse reactions were observed before and after treatment.Results The total effective rate of the observation group was 96.7%,which was significantly higher than 86.7% of the control group(χ^2=3.893,P=0.045).After treatment,the IgM,IgA,and IgG of the observation group were lower than those of the control group(t/P =6.923/0.000,9.259/0.000,9.025/<0.001),but the SLEDAI score had no significant difference(t=0.262,P =0.794).The levels of serum creatinine,urea nitrogen,and urinary protein decreased significantly in the two groups,but there was no significant difference between the two groups(P>0.05).Conclusion Protein A immunosorbent has a better therapeutic effect on lupus nephritis than traditional DNA immunosorbent.It can obviously improve the immune function of patients and has clinical application value.