大劑量免疫球蛋白對狼瘡腎治療作用研究

梁師鋼

[摘要] 目的 探討大劑量免疫球蛋白對狼瘡腎治療效果，分析大劑量免疫球蛋白的治療作用。 方法 方便選取該院于2016年10月—2018年10月收治的40例狼瘡腎炎患者作為研究對象，采用硬幣法分為對照組與觀察組，各組20例。對照組采用激素聯合環磷酰胺治療，觀察組在對照組基礎上采用大劑量免疫球蛋白治療。治療2個月觀察與比較兩組患者的系統性紅斑狼瘡病情活動度、尿蛋白、血漿白蛋白變化情況。結果 觀察組患者治療后系統性紅斑狼瘡病情活動度評分結果為（1.34±1.17）分，低于對照組，差異有統計學意義（t=6.017，P<0.05）。觀察組尿蛋白檢測結果為（1.94±1.23）g/L，低于對照組，差異有統計學意義（t=5.635，P<0.05）。觀察組治療后血漿白蛋白檢測結果為（30.14±10.15）g/L，高于對照組，差異有統計學意義（t=6.318，P<0.05）。 結論 大劑量免疫球蛋白聯合糖皮質激素、環磷酰胺治療狼瘡腎炎可以改善患者的尿蛋白、血漿白蛋白水平，具有良好的臨床治療效果，值得應用。

[關鍵詞] 狼瘡腎炎;免疫球蛋白;環磷酰胺;糖皮質激素;血漿白蛋白;效果

[中圖分類號] R4? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）06（a）-0004-03

[Abstract] Objective To investigate the therapeutic effect of high-dose immunoglobulin on lupus kidney and analyze the therapeutic effect of high-dose immunoglobulin. Methods Forty patients with lupus nephritis admitted to our hospital from October 2016 to October 2018 were convenient enrolled in the study. According to coin method， they were divided into the control group and the observation group， with 20 cases in each group. The control group was treated with glucocorticoid combined with cyclophosphamide， while the observation group was treated with high-dose immunoglobulin on the basis of the control group. Two months after treatment， the activity of systemic lupus erythematosus， urine protein and plasma albumin were observed and compared between the two groups. Results The scores of systemic lupus erythematosus activity in the observation group were （1.34±1.17）points， which was lower than the control group （t=6.017， P<0.05）， with statistical significance. The urine protein test results of the observation group were （1.94±1.23）g/L， which was lower than the control group （t=5.635， P<0.05）， with statistical significance. The plasma albumin test results of the observation group were （30.14±10.15）g/L， which was higher than that of the control group （t=6.318， P<0.05）， with statistical significance. Conclusion High-dose immunoglobulin combined with glucocorticoid and cyclophosphamide can improve the urinary protein and plasma albumin levels in patients with lupus nephritis. It has good clinical therapeutic effect and is worthy of application.

[Key words] Lupus nephritis; Immunoglobulin; Cyclophosphamide; Glucocorticoid; Plasma albumin; Effect

系統性紅斑狼瘡是臨床上常見的免疫系統疾病，臨床表現多為面部紅斑等面部損害，育齡期女性是該病的多發人群，我國系統性紅斑狼瘡發病率逐年上升。狼瘡腎炎是系統性紅斑狼瘡的并發癥，對患者的腎臟功能造成了嚴重的影響，一旦發展為終末期腎病，患者需進行腎臟移植等治療，給患者帶來了極大的經濟負擔[1]。但是，狼瘡腎炎的腎損害并非是不可逆的，通過檢查及早診斷與治療狼瘡腎炎可以盡早恢復患者的腎功能。為了進一步研究大劑量免疫球蛋白對狼瘡腎炎治療效果，該文方便選取該院于2016年10月—2018年10月收治的40例狼瘡腎炎患者作為研究對象進行對比分析，現將結果報道如下。