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目的观察大剂量免疫球蛋白静脉注射(IVIG)治疗系统性红斑狼疮(SLE)的疗效及不良反应。方法应用大剂量免疫球蛋白[0.4g/(kg·d),3～5d]静脉注射治疗16例重症SLE,观察治疗前后患者临床症状及实验室检查的变化,同时了解有无不良反应的发生。结果大剂量免疫球蛋白静脉注射后,SLE患者的临床症状(如发热、皮损、关节痛等)明显改善,同时患者的狼疮活动积分、ds-DNA抗体、血沉明显降低(P均<0.01),补体、血小板明显增高(P<0.05),但24h尿蛋白改善不明显。3例患者使用IVIG后出现不良反应。结论大剂量免疫球蛋白静脉注射治疗重症系统性红斑狼疮有较好的疗效,但应注意避免其不良反应的发生。
Objective To observe the efficacy and adverse reactions of intravenous injection of high-dose immunoglobulin (IVIG) in the treatment of systemic lupus erythematosus (SLE). Methods 16 cases of severe SLE were treated with intravenous injection of high-dose immunoglobulin [0.4g / (kg · d), 3 ~ 5d] and the changes of clinical symptoms and laboratory tests before and after treatment were observed, and the occurrence of adverse reactions was also observed . Results After intravenous injection of high-dose immunoglobulin, the clinical symptoms (such as fever, skin lesions and arthralgia) in patients with SLE were significantly improved. At the same time, the scores of lupus activity, ds-DNA antibody and erythrocyte sedimentation rate were significantly decreased in patients with SLE (all P <0.01) , Complement, platelet increased significantly (P <0.05), but 24h urine protein did not improve obviously. Three patients experienced adverse reactions after using IVIG. Conclusion Intravenous injection of high-dose immunoglobulin is effective in treating severe systemic lupus erythematosus, but care should be taken to avoid its adverse reactions.