| 石峰,杨蕙文,罗余生,喻秋平,叶兴文,李雪飞,尹海琴,余跃.CRRT联合免疫吸附对重症系统性红斑狼疮患者疾病活动指数评分(SLEDAI)及预后转归影响的研究*[J].实用中西医结合临床,2019,19(10): |
| CRRT联合免疫吸附对重症系统性红斑狼疮患者疾病活动指数评分(SLEDAI)及预后转归影响的研究* |
| Study on the effect of CRRT combined with immunosorbent on disease activity index score (SLEDAI) and prognosis in patients with severe systemic lupus erythematosus |
| 投稿时间：2019-06-19 修订日期：2019-07-05 |
| DOI： |
| 中文关键词: CRRT 免疫吸附 重症系统性红斑狼疮 系统性红斑狼疮疾病活动指数评分（SLEDAI） 预后转归。 |
| 英文关键词: CRRT.Immunosorption Severe systemic lupus erythematosus Sle disease activity index score (SLEDAI) prognosis and outcome . |
| 基金项目:江西省卫生计生委科技计划(项目编号：20197196) |
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| 中文摘要: |
| 目的 观察CRRT联合免疫吸附对重症系统性红斑狼疮患者疾病活动指数评分(SLEDAI)及预后转归的影响。方法 将31例重症SLE患者分为对照组、IA组及CRRT+IA组。所有患者入院后均按指南要求给予糖皮质激素和免疫抑制剂药物治疗。IA组采用在此基础上给予DNA免疫吸附治疗。CRRT+IA组在IA组基础上联合CRRT(连续性静-静脉血液滤过模式CVVH)治疗。疗程为收住风湿免疫科(重症监护病房)后连续3日。分析三组患者治疗前后SLE疾病活动指数评分(SLEDAI)、多器官功能障碍综合征(MODS)发生率以及28天死亡率。结果 IA组SLE疾病活动指数评分(SLEDAI)及多器官功能障碍综合征(MODS)发生率下降显著(P＜0.05)；CRRT+IA组较IA组SLE疾病活动指数评分(SLEDAI)下降显著(P＜0.05)。结论：对于重症系统性红斑狼疮患者,在传统的药物治疗基础上早期应用CRRT联合DNA免疫吸附这种多血液净化模式(集成血液净化模式)治疗,能显著改善患者临床症状,降低疾病严重程度,从而可能影响疾病的转归及预后。 |
| 英文摘要: |
| purpose To observe the effect of CRRT combined with immunosorbent on SLEDAI and prognosis in patients with severe systemic lupus erythematosus. Methods 31 patients with severe SLE were divided into control group, IA group and CRRT+IA group. All patients were treated with glucocorticoid and immunosuppressive drugs according to the guidelines after admission. Group IA was treated with DNA immunosorbent therapy on this basis. The CRRT+IA group was treated with CRRT (continuous venovenous hemofiltration mode CVVH) on the basis of the IA group. The course of treatment was for 3 consecutive days after admission to the department of rheumatology and immunology (icu). Analysis of three groups of patients before and after treatment marks SLE disease activity index (SLEDAI), the incidence of multiple organ dysfunction syndrome (MODS) and the 28-day mortality.Results The incidence of SLEDAI and MODS decreased significantly in the IA group (P < 0.05). The SLEDAI score of CRRT+IA group was significantly lower than that of IA group (P < 0.05).Conclusion: For patients with severe systemic lupus erythematosus, early application of CRRT combined with DNA immunosorption, a multi-blood purification mode (integrated blood purification mode) treatment on the basis of traditional drug treatment can significantly improve the clinical symptoms of patients and reduce the severity of the disease, thereby affecting the outcome and prognosis of the disease. |
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