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目的:研究免疫吸附疗法对急进性肾炎的治疗效果,并探讨其对血清中抗-GBM及ANCA水平的影响。方法:随机选取我院6例急进性肾炎患者作为研究对象,6例患者中,合并糖尿病-3例,合并肺部间质性炎性症状-3例。肾活检显示,新月体比例约为56.6%-5.9%。患者除应用环磷酰胺联合糖皮质激素进行治疗外,还应进行免疫吸附治疗。结果:经过单次免疫吸附治疗之后,血清中ANCA MPO明显下降,P<0.05,抗-GBM有所下降,但P>0.05。肾功能改善显著,治疗前需要透析的2例患者中,1例肾功能改善,无需透析;治疗前无需透析的4例患者,他们的肾功能也明显好转。患者肺部间质性炎性症状有显著改善。治疗前后,患者的血糖、血压、血常规、电解质、肝功能、心率、血氧饱和度及呼吸频率均相对稳定。6例患者均存活。结论:免疫吸附疗法联合环磷酰胺及糖皮质激素治疗急进性肾炎,安全可靠,疗效良好,可显著改善患者肺部病变及肾功能。
Objective: To study the therapeutic effect of immunoadsorption therapy on acute nephritis and explore its effect on serum anti-GBM and ANCA levels. Methods: Six patients with acute nephritis in our hospital were randomly selected as the research object. Among the 6 patients, 3 were complicated with diabetes mellitus, and 3 were complicated with pulmonary interstitial inflammatory symptoms. Renal biopsy showed crescent proportions of about 56.6% -5.9%. In addition to the application of cyclophosphamide in combination with glucocorticoid therapy, but also for immunosuppressive therapy. Results: After a single immunosuppression, serum ANCA MPO was significantly decreased, P <0.05, anti-GBM decreased, but P> 0.05. Among the 2 patients requiring dialysis prior to treatment, 1 had improved renal function without dialysis; 4 patients without dialysis prior to treatment also had significantly improved renal function. Patients with interstitial lung inflammatory symptoms have significantly improved. Before and after treatment, the patient’s blood glucose, blood pressure, blood, electrolytes, liver function, heart rate, oxygen saturation and respiratory rate were relatively stable. All 6 patients survived. Conclusion: The combination of immunosuppressive therapy and cyclophosphamide and glucocorticoid in the treatment of acute nephritis is safe, reliable and effective. It can significantly improve lung lesions and renal function in patients.