CRRT联合免疫吸附对重症系统性红斑狼疮患者疾病活动
指数评分及预后转归影响研究

石峰; 杨蕙文; 罗余生; 喻秋平; 叶兴文; 李雪飞; 尹海琴; 余跃

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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及预后转归影响研究[J].实用中西医结合临床,2019,19(10):3-4.36

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及预后转归影响研究

Study on the Effect of CRRT Combined with Immunosorbent on Disease Activity Index Score and Prognosis in Patients with Severe Systemic Lupus Erythematosus

DOI：

中文关键词: 重症系统性红斑狼疮连续性肾脏替代疗法免疫吸附

英文关键词: Severe systemic lupus erythematosus CRRT Immunosorption

基金项目:江西省卫生计生委科技计划项目（编号：20197196）

作者	单位
石峰，杨蕙文，罗余生，喻秋平，叶兴文，李雪飞，尹海琴，余跃	九江学院附属医院

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中文摘要:

目的：观察连续性肾脏替代疗法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及预后转归的影响。方法：将31例重症系统性红斑狼疮患者分为对照组、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组在上述治疗基础上给予DNA免疫吸附治疗。CRRT+IA组在IA组治疗基础上联合连续性肾脏替代疗法（连续性静-静脉血液滤过模式）治疗。分析三组治疗前后系统性红斑狼疮疾病活动指数评分、多器官功能障碍综合征发生率以及28 d病死率。结果：治疗后对照组系统性红斑狼疮疾病活动指数评分与治疗前比较有所下降，但差异均无统计学意义（P＞0.05）。IA组和CRRT+IA组治疗后系统性红斑狼疮疾病活动指数评分均较治疗前显著下降，差异均有统计学意义（P＜0.05），且CRRT+IA组治疗后系统性红斑狼疮疾病活动指数评分较IA组下降明显（P＜0.05）。IA组和CRRT+IA组多器官功能障碍综合征发生率均明显低于对照组（P＜0.05），IA组和CRRT+IA组多器官功能障碍综合征发生率比较，差异无统计学意义（P＜0.05）。三组28 d病死率比较，差异无统计学意义（P＞0.05）。结论：在传统的药物治疗基础上早期应用连续性肾脏替代疗法联合DNA免疫吸附治疗重症系统性红斑狼疮患者，能显著改善患者临床症状，降低疾病严重程度，从而改善疾病的转归及预后。

英文摘要:

Objective: 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. The IA group was treated with DNA immunosorbent therapy on this basis. The CRRT+IA group was treated with CRRT (continuous venovenous hemofiltration mode) on the basis of the IA group. The marks SLE disease activity index, the incidence of multiple organ dysfunction syndrome (MODS) and the 28-day mortality were analysed before and after treatment in three groups. Results: After the treatment, the scores of SLEDAI were decreased than before treatment, but there was no significant difference in the control group. The SLEDAI score of CRRT+IA group and IA group were decreased than before treatment, the differences were statistically significant. The CRRT+IA group was significantly lower than that of the IA group (P＜0.05). The incidence of MODS in IA group and CRRT+IA group was lower than that in control group(P＜0.05). The incidence of MODS in IA group and CRRT+IA group was not statistically significant(P＞0.05). Three groups of 28-day mortality were compared, the difference was not statistically significant(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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