免疫吸附治疗重度活动性系统性红斑狼疮的疗效观察

目的探讨应用DNA-280免疫吸附治疗重度活动性系统性红斑狼疮患者的临床疗效及安全性。方法应用DNA-280免疫吸附柱对10例重度活动性系统性红斑狼疮患者进行免疫吸附治疗，观察吸附治疗前后患者症状、抗核抗体（ANA）、抗dsDNA抗体、IgG、补体C3、C4水平、血常规、肝功能、肾功能、电解质、系统性红斑狼疮疾病活动指数（SLEDAI评分），并随访观察。结果经免疫吸附治疗后，患者SLEDAI评分下降，ANA、抗dsDNA抗体滴度、免疫球蛋白IgG水平下降，补体C3、C4水平升高（P〈0．05），治疗前后血常规、肝功能、肾功能、电解质无明显变化（P〉0．05），整个吸附过程患者均能较好地耐受。所有患者随访观察2年，患者病情稳定（SLEDAI≤4分）。结论免疫吸附能迅速消除系统性红斑狼疮患者体内的自身抗体，控制狼疮活动；采用DNA-280免疫吸附治疗重度活动性系统性红斑狼疮安全有效。

Clinical Effectiveness of Immunoadsorption in Treatment of Severe Systemic Lupus Erythematosus

Objective To evaluate the effectiveness and safety of DNA immunoadsorption in treatment of severe systemic lupus erythematosus.Methods Ten patients with severe systemic lupus erythematosus were treated with DNA immunoadsorption column and detect the titres of ANA and dsDNA in pre-treatment and after-treatment,the concentrations of IgG antibody, C3,C4 and change of blood routine,liver function,kidney function,electrolyte,systemic lupus erythematosus disease activity index（SLEDAI）,then observation lasted two years.Results SLEDAI,the titres of ANA and dsDNA decreased and the level of C3,C4 increased after treatment which was significant difference compared with pretreatment（P 〈 0.05）,blood routine,liver function,kidney function,electrolyte had no significant change（P 〉 0.05）,all patients could be tolerable to immunoadsorption,all patients who were followed up for two years were in stable condition（SLEDAI≤4）.Conclusion DNA immunoadsorption could rapidly remove autoantibodies in systemic lupus erythematosus.The immunoadsorption in treatment of severe systemic lupus erythematosus is safe without obvious side effects.