免疫吸附治疗重症狼疮有效

作者：Huang J, et al.
翻译：江苏连云港中医院赵争敏（zhengminzhao@126.com）
发布：孙琳
审核：姚中强




免疫吸附（IAS）联合治疗糖皮质激素和免疫抑制剂治疗重症系统性红斑狼疮（SLE）疗效和安全性的分析。所有入选患者重要脏器受累，包括蛋白尿，血小板减少症，心包积液，和需要皮质类固醇激素治疗的脑受累。免疫吸附组52例，接受IAS联合糖皮质激素和环磷酰胺治疗。非免疫吸附组52例，给予糖皮质激素和环磷酰胺治疗。测量指标包括C3、dsDNA、AnuA、SLE疾病活动指数（SLEDAI），在特殊情况下，进行尿蛋白定量及血小板计数。两组疾病活动度均明显下降。免疫吸附组疾病活动指标的改善明显优于非免疫吸附组。免疫吸附组类固醇剂量低，显示了在激素减量情况下免疫吸附的作用。在免疫吸附过程中没有发生严重不良反应。我们的研究表明，免疫吸附作为治疗重症SLE激素和免疫抑制剂治疗之外的一种治疗方法。







附原文：

Abstract This was an exploratory analysis comparing the safety and efficacy of immunoadsorption (IAS) combination therapy in severe systemic lupus erythematosus (SLE) receiving corticosteroid pulse and immunosuppressant treatment. Patients enrolled all h predominant organ involvement including proteinuria, thrombocytopenia, pericardial effusion, and cerebral involvement requiring corticosteroid pulse treatment. Fifty-twopatients in study group received IAS plus corticosteroid and cyclophosphamide treatment. Fifty-two patients in non-IAS group received corticosteroid and cyclophosphamide treatment. Outcome measurement included C3, dsDNA, AnuA, and SLE disease activity index (SLEDAI) 2k score and in particular cases, proteinuria quantification and platelet count. Disease activity dropped significantly in both groups. Improvement of disease activity markers was more significant in study group than that in non-IAS group. The lower dosage of steroid in study group suggested the steroid-sparing effect of IAS. No severe adverse effect occurred during IAS. Our study suggested IAS as an additional therapy to steroid pulse and immunosuppressant in treating severe SLE.


引自：
Huang J, Song G, Yin Z, He W, Zhang L, Kong W, Ye Z. Rapid reduction of antibodies and improvement of disease activity by immunoadsorption in Chinese patients with severe systemic lupus erythematosus. Clin Rheumatol. 2016 Aug 3. [Epub ahead of print]