大剂量免疫球蛋白对狼疮肾治疗作用研究

梁师钢

[摘要] 目的 探讨大剂量免疫球蛋白对狼疮肾治疗效果，分析大剂量免疫球蛋白的治疗作用。 方法 方便选取该院于2016年10月—2018年10月收治的40例狼疮肾炎患者作为研究对象，采用硬币法分为对照组与观察组，各组20例。对照组采用激素联合环磷酰胺治疗，观察组在对照组基础上采用大剂量免疫球蛋白治疗。治疗2个月观察与比较两组患者的系统性红斑狼疮病情活动度、尿蛋白、血浆白蛋白变化情况。结果 观察组患者治疗后系统性红斑狼疮病情活动度评分结果为（1.34±1.17）分，低于对照组，差异有统计学意义（t=6.017，P<0.05）。观察组尿蛋白检测结果为（1.94±1.23）g/L，低于对照组，差异有统计学意义（t=5.635，P<0.05）。观察组治疗后血浆白蛋白检测结果为（30.14±10.15）g/L，高于对照组，差异有统计学意义（t=6.318，P<0.05）。 结论 大剂量免疫球蛋白联合糖皮质激素、环磷酰胺治疗狼疮肾炎可以改善患者的尿蛋白、血浆白蛋白水平，具有良好的临床治疗效果，值得应用。

[关键词] 狼疮肾炎;免疫球蛋白;环磷酰胺;糖皮质激素;血浆白蛋白;效果

[中图分类号] R4          [文献标识码] A          [文章编号] 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

系统性红斑狼疮是临床上常见的免疫系统疾病，临床表现多为面部红斑等面部损害，育龄期女性是该病的多发人群，我国系统性红斑狼疮发病率逐年上升。狼瘡肾炎是系统性红斑狼疮的并发症，对患者的肾脏功能造成了严重的影响，一旦发展为终末期肾病，患者需进行肾脏移植等治疗，给患者带来了极大的经济负担[1]。但是，狼疮肾炎的肾损害并非是不可逆的，通过检查及早诊断与治疗狼疮肾炎可以尽早恢复患者的肾功能。为了进一步研究大剂量免疫球蛋白对狼疮肾炎治疗效果，该文方便选取该院于2016年10月—2018年10月收治的40例狼疮肾炎患者作为研究对象进行对比分析，现将结果报道如下。