连续性血液净化治疗狼疮性肾炎并急性肾损伤的效果及对患者炎性因子、免疫功能的影响

Effect of continuous blood purification in the treatment of lupus nephritis with acute kidney injury and its influence on inflammatory factors and immune function

目的探讨连续性血液净化治疗狼疮性肾炎(LN)并急性肾损伤(AKI)的效果及对患者炎性因子、免疫功能的影响。方法抽取2018年1月至2021年5月郑州市第七人民医院收治的LN并AKI患者82例,按照随机数字表法分为观察组41例和对照组41例。对照组患者采取常规治疗,观察组在对照组基础上结合连续性血液净化治疗。比较两组疗效,治疗前后肾功能、24 h尿蛋白定量、炎性因子和免疫功能变化。结果观察组治疗总有效率(92.68%)高于对照组的70.73%(P<0.05)。两组治疗后血肌酐和尿素氮水平低于治疗前(P<0.05);观察组治疗后血肌酐和尿素氮水平低于对照组(P<0.05)。两组治疗后24 h尿蛋白定量水平低于治疗前(P<0.05);观察组治疗后24 h尿蛋白定量水平低于对照组(P<0.05)。两组治疗后肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和C-反应蛋白(CRP)水平低于治疗前(P<0.05);观察组治疗后TNF-α、IL-6和CRP水平低于对照组(P<0.05)。两组治疗后CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平高于治疗前(P<0.05);观察组治疗后CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平高于对照组(P<0.05)。结论连续性血液净化治疗LN并AKI患者的效果良好,可减轻炎性反应,改善患者免疫功能。

Objective To investigate the effect of continuous blood purification in the treatment of lupus nephritis(LN)and acute kidney injury(AKI)and its influence on the inflammatory factors and immune function.Methods A total of 82 patients with LN and AKI in Zhengzhou Seventh People’s Hospital from January 2018 to May 2021 were selected and divided into observation group(41 cases)and control group(41 cases)according to the random number table method.Patients in the control group received conventional treatment,and the observation group combined continuous blood purification treatment on the basis of the control group.The changes in renal function,24 h urine protein quantification,inflammatory factors and immune function were compared between the two groups before and after treatment.Results The total effective rate of the observation group(92.68%)was higher than 70.73%of control group(P<0.05).The serum creatinine and urea nitrogen levels of the two groups after treatment were lower than those before treatment(P<0.05);the serum creatinine and urea nitrogen levels of the observation group after treatment were lower control group than those of the control group(P<0.05).The quantitative level of urine protein of the two groups was lower than that before treatment(P<0.05);the quantitative level of urine protein of the observation group was lower that of the control group(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)in the two groups after treatment were lower than those before treatment(P<0.05);the levels of TNF-α,IL-6 and CRP of the observation group were lower than those of the control group after treatment(P<0.05).The levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the two groups of LN patients with AKI after treatment were higher than those before treatment(P<0.05);the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in patients with LN and AKI in the observation group after treatment were higher than those of the control group(P<0.05).Conclusions Continuous blood purification has a good effect in the treatment of patients with LN and AKI,and can reduce the inflammatory response and improve the immune function of patients.