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目的探讨DNA免疫吸附治疗儿童重症狼疮的近期临床疗效和安全性。方法2007年4月至2008年7月中国医科大学附属盛京医院小儿肾脏内科对9例重症狼疮患儿采用血液灌流DNA免疫吸附柱对每例进行3次吸附。观察其临床表现、对ANA、ds-DNA等自身抗体的清除效果,对免疫球蛋白、血清补体、24h尿蛋白定量、血常规、肝、肾功能、心肌酶谱、血清离子、血沉的影响。结果DNA免疫吸附后患儿的症状和体征均明显改善;ANA抗体滴度吸附后明显下降[(2515.56±1772.62)及(477.89±272.31),P<0.001];抗ds-DNA抗体被完全清除,其它自身抗体也被清除;免疫球蛋白IgG吸附后下降明显[(14.47±5.07)g/L及(8.53±1.30]g/L,P<0.001];血清补体有上升趋势,24h尿蛋白有下降趋势;对肝、肾功能、心肌酶谱、血清离子、血沉无明显影响,有4例血小板下降。结论DNA免疫吸附疗法能够在短时间内清除重症狼疮患儿体内抗ds-DNA和ANA抗体等免疫物质,使患儿度过免疫风暴导致的危重期,且具有较好的安全性。
Objective To investigate the recent clinical efficacy and safety of DNA immunosorbent in the treatment of children with severe lupus. Methods From April 2007 to July 2008, Pediatric Nephrology, Shengjing Hospital Affiliated to China Medical University, 9 children with severe lupus were enrolled in this study with blood perfusion DNA immuno-adsorption column. To observe the clinical manifestations, clearance of ANA, ds-DNA and other autoantibodies, immunoglobulin, serum complement, 24h urinary protein, blood, liver, kidney function, myocardial enzymes, serum ions, erythrocyte sedimentation rate. Results The symptoms and signs of children with DNA immunosorbent were significantly improved. The antibody titer of ANA decreased obviously after being adsorbed [(2515.56 ± 1772.62) vs (477.89 ± 272.31), P <0.001]. Anti-dsDNA antibody was completely eliminated, Other autoantibodies were also cleared; the immunoglobulin IgG decreased significantly after adsorption ([14.47 ± 5.07] g / L and (8.53 ± 1.30] g / L, P <0.001]; serum complement increased and urine protein decreased Trend, no significant effect on liver, renal function, myocardial enzymes, serum ion and erythrocyte sedimentation rate, and 4 cases of platelet decrease.Conclusion DNA immunoabsorption therapy can clear anti-dsDNA and ANA antibody in children with severe lupus in a short time Immune substances, so that children with immune crisis through the critical period, and has good safety.