连续性血液净化对狼疮肾炎合并急性肾损伤患者免疫功能和炎性因子的影响

The effect of continuous blood purification on the immune function and the level of inflammatory factor in patients with lupus nephritis and acute kidney injury

目的探讨连续性血液净化(continuous blood purification,CBP)对狼疮肾炎合并急性肾损伤患者免疫功能和炎性因子的影响。方法选取2016年3月至2018年12月在鄂州市中心医院接受治疗的狼疮肾炎合并急性肾损伤患者71例为研究对象,以奇偶分组法将患者分为试验组(35例)和对照组(36例)。两组患者均给予口服泼尼松+环磷酰胺治疗,在此基础上,试验组患者采用CBP治疗,对照组患者采用间歇性血液透析治疗。观察两组患者治疗前后免疫功能和炎性因子水平变化。结果治疗后,两组患者血肌酐、血尿素氮、24 h蛋白尿、白介素-6、白介素-13、肿瘤坏死因子-α、C反应蛋白水平均较本组治疗前显著降低(均P<0.01),试验组患者上述指标水平均显著低于对照组(均P<0.01);试验组患者的CD3+T细胞和CD8+T细胞占比均显著低于对照组(均P<0.05),CD4+T细胞占比显著高于对照组(P<0.05)。结论CBP能够降低狼疮肾炎合并急性肾损伤患者体内的炎性因子水平,保护肾功能,调节免疫功能,具有临床应用价值。

Objective To analyze and discuss the effects of continuous blood purification(CBP)on the immune function and inflammatory factor level of patient with lupus nephritis combined with acute kidney injury.Method Seventy-one patients with lupus nephritis combined with acute kidney injury who were treated in Ezhou Central Hospital from March 2016 to December 2018 were selected as study subjects and they were divided into experimental group(35 cases)and control group(36 cases)by odd-even grouping method.Patients in both groups were given oral prednisone+cyclophosphamide.On this basis,patients in experimental group were treated with CBP,while patients in control group were treated with intermittent hemodialysis.The changes of immune function and inflammatory factors were observed before and after treatment.Result After treatment,serum creatinine,blood urea nitrogen,24 h proteinuria,interleukin-6,interleukin-13,tumor necrosis factor-α,and C reactive protein levels in both groups were significantly lower than those before treatment(all P<0.01),the above indexes of experimental group were significantly lower than those of control group(all P<0.01).The proportion of CD3+T cells and CD8+T cells in experimental group were significantly lower than those in control group(all P<0.05),and the proportion of CD4+T cells was significantly higher than that in control group(P<0.05).Conclusion CBP can reduce inflammatory factors in patients with lupus nephritis complicated with acute kidney injury,protect renal function and regulate immune function,and has clinical application value.