DNA免疫吸附治疗儿童重度活动系统性红斑狼疮近期疗效研究

摘要

Objective To evaluate the short - term therapeutic effects of DNA immunoadsorption ( IA ) therapy in children with severe systemic lupus erythematosus ( SLE ). Methods DNA - IA was performed in 12 SLE patients, all scored a-bove 15 in Systemic Lupus Erythematosus Disease Activity Index ( SLEDAI ) evaluation before treatment and were diagnosed as severely active. Eleven cases received routine DNA - IA therapy of 3 times, while the other case received DNA - IA therapy twice. Levels of anti - nuclear antibody ( ANA ), ds - DNA, erythrocyte sedimentation rate ( ESR ), immunoglobulin, complements , blood routine test, hepatic and renal function, and 24h - urinary protein were examined both before and after treatment. Results The symptoms and signs were improved after IA therapy with the SLEDAI scores, ANA titers, anti - ds - DNA antibody levels, ESR, serum IgG, and urinary protein decreased significantly while complement C3 increased on the other hand (P＜0. 05). No significant changes in serum IgA, IgM, C4 , blood routine test, hepatic and renal function were noted. No serious complications during the IA process were found. Conclusion DNA - IA is effective in treating children with severe systemic lupus erythematosus and further studies have yet to be carried out to evaluate its long - term effects.%目的 评价DNA免疫吸附(DNA immunoadsorption,DNA-IA)治疗儿童重度活动系统性红斑狼疮(SLE)的近期疗效.方法 对12例儿童SLE患者进行DNA-IA治疗.所有患儿DNA-IA治疗前系统性红斑狼疮疾病活动度(SLEDAI)评分均＞15分,为重度活动.11例患儿常规行3次DNA-IA治疗,1例行2次治疗.DNA-IA治疗前后行抗核抗体(ANA)、抗双链DNA(ds-DNA)抗体、红细胞沉降率、免疫球蛋白、补体、血常规、肝肾功能、24 h尿蛋白定量等检查.结果 DNA-IA治疗后患儿症状体征明显好转,SLEDAI评分明显下降,ANA滴度明显下降,抗ds-DNA抗体明显下降,补体C3明显上升,红细胞沉降率和血清IgG明显下降,尿蛋白定量明显下降,与治疗前比较差异均有统计学意义(P＜0.05);血清IgA、IgM、补体C4、血常规、肝肾功能等无明显变化.DNA-IA过程中无一例出现严重并发症.结论 DNA-IA是治疗儿童重度活动SLE的有效方法,还需进一步的对照研究观察其远期疗效.