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目的观察血浆置换联合激素和免疫抑制剂方案治疗系统性红斑狼疮的疗效,并观察其不良反应。方法 30例初诊红斑狼疮患者通过投掷硬币法分为治疗组和对照组,治疗组15例行血浆置换联合强的松和环磷酰胺治疗,对照组15例单用强的松和环磷酰胺治疗,观察2组治疗后临床症状、实验室资料及药物不良反应数据。结果治疗后2组间血小板、血沉、补体C4、白蛋白、IgA、IgM、γ-球蛋白比较差异均有统计学意义(P均<0.05);治疗组发热、红斑、关节痛好转率(100%、93.3%和93.3%)均明显高于对照组(73.3%、53.3%和60.0%),P均<0.05。治疗组出现低钙手足抽搐3例,未见其他不良反应。结论血浆置换联合激素和免疫抑制剂治疗系统性红斑狼疮可使患者的临床症状和化验指标得到明显改善,提高临床疗效。
Objective To observe the curative effect of plasma exchange combined with hormone and immunosuppressive regimen on systemic lupus erythematosus (SLE) and to observe its adverse reactions. Methods Thirty newly diagnosed patients with lupus erythematosus were divided into treatment group and control group by coin-throwing method. Fifteen patients in the treatment group were treated with plasma exchange combined with prednisone and cyclophosphamide. Fifteen patients in the control group were treated with prednisone and cyclophosphamide The clinical symptoms, laboratory data and adverse drug reaction data of two groups were observed. Results The difference of platelet count, erythrocyte sedimentation rate, complement C4, albumin, IgA, IgM and γ-globulin between the two groups after treatment was statistically significant (all P <0.05). The improvement rates of fever, %, 93.3% and 93.3% respectively) were significantly higher than those in the control group (73.3%, 53.3% and 60.0%, P <0.05). The treatment group appeared in 3 cases of calcium deficiency hand-foot twitch, no other adverse reactions. Conclusion Plasma exchange combined with hormone and immunosuppressive agents in the treatment of systemic lupus erythematosus can improve the clinical symptoms and laboratory parameters of patients, and improve the clinical efficacy.