不同免疫吸附方法治疗系统性红斑狼疮的对比研究

目的比较A蛋白免疫吸附、PH350免疫吸附、DNA免疫吸附对系统性红斑狼疮的治疗效果。方法 98例系统性红斑狼疮患者,根据选择免疫吸附治疗的方式分为3组,观察治疗前后患者尿蛋白定量、血肌酐、尿素氮、白蛋白、免疫球蛋白、补体、自身抗体(抗核抗体、抗双链DNA抗体)、活动指数、器官功能等。结果治疗前后比较,患者尿蛋白定量、血肌酐、尿素氮、免疫球蛋白、自身抗体显著下降(均P0.05),其中A蛋白吸附与其他两种治疗方法免疫球蛋白清除率差异有统计学意义(均P0.05)。随观察时间的延长,不同方法的狼疮活动控制情况差异无统计学意义(P0.05)。结论不同免疫吸附治疗方法均可对系统性红斑狼疮取得较好的病情控制效果,但A蛋白对自身抗体清除更彻底。在临床实践中应综合考虑,选择最佳治疗方案。

The comparison study On different immunoadsorption methods for the treatment of systemic lupus erythematosus

Objective To investigate the clinically curative effects of different therapeutic methods of immunoadsorption （protein A immunoadsorption, PH350 immunoadsorption, DNA immunoadsorption） for systemic lupus erythematosus （SLE）. Methods A total of 98 SLE patients were divided into three groups according to the immunoadsorption method used. Before and after the therapy, 24-hour urinary protein, serum creatinine （Cr）, urea nitrogen （UN）, albumin, immunoglobulin level, complement C3 and C4, autoantibodies （ANA and anti-dsDNA autoantibody） and SLEDAI score were measured. Results There were significant changes in 24-hour urinary protein, serum creatinine （Cr）, urea nitrogen （UN）, albumin, immunoglobulin level, autoantibodies （anti-dsDNA autoantibody）, and SLEDAI score before and after the therapy （all P〈0.05）. Furthermore, the clearance of immunoglobulin was more efficient in protein A group than in PH350 group and DNA group （P〈0.05）. However, there were no differences in lupus activity control among patients using different immunoadsorption methods after longer period of observation. Conclusion The curative effects of immunoadsorption methods on SLE were significant. Among the immunoadsorption methods we used, protein A was more effective in autoantibody clearance. In clinical practice, a variety of factors should be considered in choosing the best immunoadsorption methods.