DNA免疫吸附剂血液灌流治疗系统性红斑狼疮临床应用研究

CLINICAL STUDY OF DNA IMMUNOADSORBENT FOR HEMOPERFUSION IN SYSTEMIC LUPUS ERYTHEMATOSUS THERAPY

目的 :应用DNA免疫吸附剂 ,对系统性红斑狼疮 (SLE)患者进行血液灌流治疗 ,以清除致病抗体及其免疫复合物 ,使血液得到净化以治疗疾病。方法 :将患者动脉血液流经血液灌流仪 ,以保温 (38℃± )和保持流速(2 0 0ml/min)进入DNA免疫吸附罐 ,在罐内经吸附后由静脉回输入体内。吸附 1次需 1.5～ 2h ,使患者体内血液流经 3～ 4遍。结果 :32例SLE患者吸附后 1～ 2天发热、乏力、关节痛消失 ,2周皮损 87.5 %消失 ,1周各项检测异常指标皆达正常参考值内。而血中有形成份红细胞、白细胞、血小板则无影响。所治疗 32例SLE患者已随访 12～ 4 4个月 ,与未用此法治疗的对比组 34例SLE患者相比 ,生活质量明显提高 ,病死率显著下降 (P <0 .0 1)。结论 :用DNA免疫吸附剂进行血液灌流的净化疗法是特异性强、疗效高、无菌、无毒性、无致热源、无溶血反应。

Systemic Lupus Erythematosus(SLE) is considered as a prototype of auto-immune disease and its pathogenic mechanism is not yet clearly understood, but abnormally high levels of anti-DNA antibodies and their immune complexes in the blood of the patients are the main characteristic and correlates well with the organs injury and the patients symptoms. Extracorporeal immunoadsorption with DNA immunoadsorbent can specifically remove pathogenic substances. The immunoadsorbent formed by coating calf thymus DNA on carbonized beads by collodion was made by Nankai University and applied in treating 32 SLE patients. The results showed that the levels of the pathogenic antibodies of all the patients were decreased to normal range. Urine protein and erythrocyte sedimentation rate were also improved. Nearly all the symptoms were relieved or eliminated after the perfusion. The patients were followed up for 12-44 months, which showed that the extracorporeal hemoperfusion with DNA immunoadsorbent is an effective therapy for late SLE patients.