• DNA免疫吸附序贯联合免疫抑制剂治疗系统性红斑狼疮的临床观察
  • 董莉.DNA免疫吸附序贯联合免疫抑制剂治疗系统性红斑狼疮的临床观察[J].内科急危重症杂志,2022,28(2):108-112
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    DOI:10.11768/nkjwzzzz20220205
    中文关键词:  DNA免疫吸附  抗dsDNA抗体  免疫抑制剂
    英文关键词:
    基金项目:荆州市科技计划发展项目(No:2018083)
    作者单位E-mail
    董莉 荆州市中心医院(长江大学附属荆州医院) susan-2001@163.com 
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    中文摘要:
          目的:观察DNA免疫吸附治疗对系统性红斑狼疮(SLE)患者抗dsDNA抗体的清除作用以及序贯联合免疫抑制剂治疗的疗效反应。方法:收集2017年8月至2021年8月荆州市中心医院风湿免疫科收治的SLE患者,选择体内抗dsDNA抗体高滴度阳性的活动期SLE患者36例,常规治疗基础上联合DNA免疫吸附治疗,观察患者治疗前、后自身抗体及血液生化指标的变化,吸附治疗后给予免疫抑制剂,随访至少12周。结果:吸附治疗后患者体内抗dsDNA抗体滴度显著下降,平均降幅(66.4%±12.8%),高滴度抗核抗体的患者显著减少。随访中,33例患者病情维持稳定,3例患者在1~2年后,抗dsDNA抗体再次上升,重复行DNA免疫吸附治疗,病情稳定。结论:DNA免疫吸附可以在短期内明显清除抗dsDNA抗体,有助于快速缓解病情,序贯联合免疫抑制剂治疗有助于实现疾病的长期稳定。
    英文摘要:
          Objective: To observe the curative effect of DNA immunoadsorption on the clearance of anti-dsDNA antibodies in patients with systemic lupus erythematosus (SLE) and the efficacy response to sequential therapy combined with immunosuppressant therapy. Methods: A total of 36 patients with active SLE with high titer anti-dsDNA antibody were collected from Department of Rheumatology and Immunology of Jingzhou Central Hospital from August 2017 to August 2021. Patients were treated with DNA immunoadsorption on the basis of conventional treatment. The changes of autoantibodies and blood biochemical indicators were observed before and after treatment. Immunosuppressants were given after adsorption treatment. The patients were followed up for at least 12 weeks. Results: The titer of anti-dsDNA antibody in patients decreased significantly after DNA immunoadsorption therapy, with an average decrease of (66.4%±12.8%), and the number of patients with high titer of ANA decreased significantly. During the follow-up, 33 patients remained stable, and anti-dsDNA antibody in 3 patients increased again after 1 to 2 years, with repeated DNA immunoadsorption treatment and a stable condition. Conclusion: DNA immunoadsorption can significantly eliminate anti-dsDNA antibody in a short period of time, which is helpful to rapid remission of the disease, and sequential therapy in combination with immunosuppressant can help patients achieve long-term stability of the disease.