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目的:探讨2种完全不同的血浆置换液进行血浆置换(PE)治疗重型系统性红斑狼疮的临床疗效。方法:按补充置换液的不同成分将患者分成病毒灭活血浆组和白蛋白加林格液加706代血浆组。分析2组重型系统性红斑狼疮患者血浆置换前后血清中IgG、IgA、IgM、ESR、C3、CRP、BUN、Cr指标的变化,临床疗效及血浆置换后不良反应发生率。结果:2组重型系统性红斑狼疮患者经血浆置换后,血清中的各项实验室指标较血浆置换前均发生明显改变,临床症状均有改善;第1组除IgM无明显变化外,其余7项实验室指标与置换前比较,结果明显下降,差异均有统计学意义(均P<0.01);第2组的试验室指标IgM、IgA、CRP、C3与置换前相比,差异无统计学意义(P>0.05),IgG、ESR、BUN、CREA与置换前相比,差异均有计学意义(均P<0.01)。第1患者的总有效率(94.7%)与第2患者的总有效率(77.3%)相比较,差异有统计学意义(P<0.01)。2患者发生血浆置换不良反应率分别为13.2%和14.6%,差异无统计学意义(P>0.05)。结论:用病毒灭活血浆置换液治疗重型系统性红斑狼疮临床疗效优于由白蛋白、林格液、706代血浆组成的血浆置换液,但不良反应差异无统计学意义。
Objective: To investigate the clinical effects of two completely different plasma exchangers for plasma exchange (PE) in the treatment of severe systemic lupus erythematosus. Methods: The patients were divided into virus-inactivated plasma group and albumin Gallinger’s fluid plus 706-generation plasma group according to different components of replacement fluid. Serum levels of IgG, IgA, IgM, ESR, C3, CRP, BUN and Cr in patients with systemic lupus erythematosus before and after plasma exchange were analyzed. The clinical efficacy and the incidence of adverse reactions after plasma exchange were analyzed. Results: In the two groups of patients with systemic lupus erythematosus after plasma exchange, the serum of the laboratory indicators than before plasma exchange were significantly changed, the clinical symptoms were improved; the first group except IgM no significant change, the other 7 There was no significant difference between the two groups in the laboratory parameters IgM, IgA, CRP, C3 before and after transposition, the results were significantly decreased (all P <0.01) Significance (P> 0.05). There were significant differences in IgG, ESR, BUN and CREA before and after replacement (all P <0.01). The total effective rate (94.7%) in the first patient and the second patient (77.3%) were significantly different (P <0.01). 2 patients had a rate of plasma exchange adverse reactions were 13.2% and 14.6%, the difference was not statistically significant (P> 0.05). Conclusion: The clinical efficacy of virus inactivated plasma exchange solution in the treatment of severe systemic lupus erythematosus is better than that of albumin, Ringer’s solution and 706-generation plasma, but the difference in adverse reactions is not statistically significant.