狼疮肾炎合并抗磷脂抗体综合征的中西医结合诊疗

Diagnosis and treatment of lupus nephritis complicated with antiphospholipid syndrome by integrated Chinese and western medicine

抗磷脂抗体综合征(APS)是系统性红斑狼疮(SLE)常见继发病症。以循环中出现抗磷脂抗体、血栓形成和病态妊娠为特征性表现。合并APS的狼疮肾炎(LN)患者易出现更多并发症,预后较差,对治疗的敏感性降低。抗凝和(或)抗血小板是治疗LN合并APS的关键,血浆置换则对重症APS患者有一定疗效。近年来,新型药物与治疗方法如利伐沙班、美罗华及干细胞移植展现出了巨大的治疗潜力。中西医结合治疗是另一种极有希望的治疗方法,多位中医大家均认为活血化瘀法可有效治疗LN合并APS患者。现代临床与药理研究也发现了中药治疗LN合并APS的价值。

Antiphospholipid syndrome(APS)is a common secondary condition of systemic lupus erythematosus(SLE),and is characterized by the appearance of antiphospholipid antibodies in the circulation,thrombosis,and pathological pregnancy.Patients with lupus nephritis(LN)complicated with APS are prone to more complications,have poor prognosis,and are less sensitive to treatment.Treatments of anticoagulation and/or antiplatelet are the key to the therapy of LN with APS,and plasma exchange has a certain effect in patients with severe APS.In recent years,new drugs and treatments such as rivaroxaban,rituximab,and stem cell transplantation have shown great therapeutic potential.The integrated traditional Chinese and western medicine is another promising treatment,and many famous traditional Chinese medicine doctors believe that the promoting blood circulation and removing blood stasis therapy is effective in treating LN patients complicated with APS.Modern clinical and pharmacological studies have also found the value of traditional Chinese medicine in the treatment of LN complicated with APS.