Efficacy of Double Filtration Plasmapheresis Combined with Immunosuppressant in the Treatment of Severe Lupus Nephritis and Its Influence on Levels of Peripheral Blood Alb BUN and WBC
Abstract：Objective: To observe the efficacy of double filtration plasmapheresis (DFPP) combined with immunosuppressant in the treatment of severe lupus nephritis (LN) and its influence on the levels of peripheral blood urinary Albumin (Alb), blood urea nitrogen (BUN) and white blood cell (WBC). Methods: Patients with severe lupus nephritis who were treated in the hospital between January 2019 and December 2020 were retrospectively analyzed, and they were divided into observation group (n=67) and routine group (n=75) according to the treatment regimens. The routine group was treated with immunosuppressant and hormone, and the observation group was administered double filtration plasmapheresis on this basis. The clinical efficacy, liver-kidney function indicators, immune indicators and occurrence of adverse reactions were compared between the two groups after 6 months of treatment. Results: After treatment, the total remission rate of observation group was significantly higher than that of routine group (93.33% vs 79.10%) (P<0.05). After 6 months of treatment, the levels of Alb and serum total bilirubin (TBIL) of the two groups of patients were significantly enhanced compared to before treatment (P<0.05) while the levels of BUN, serum creatinine (Scr) and urine protein were significantly decreased compared to before treatment (P<0.05), and the differences between the groups were statistically significant after treatment (P<0.05). There was no statistical significance in the difference of urine protein before and after treatment between the two groups (P>0.05), and there were statistical significance in the differences of Alb, BUN, Scr and TBIL (P<0.05). After 6 months of treatment, the positive rate of anti-DsDNA antibody and levels of WBC and vascular cell adhesion molecule-1 (VCAM-1) in the two groups were significantly lower than those before treatment (P<0.05) while the level of complement C3 was significantly higher than that before treatment (P<0.05), and there were statistically significant differences between the two groups after treatment (P<0.05). There was no statistical significance in the difference of positive rate of DsDNA antibody before and after treatment between the two groups(P>0.05), but there were statistical significance in the differences of WBC level, urine VCAM-1 level and complement C3 level (P<0.05). During treatment, the incidence rate of adverse reactions was 18.67% in observation group and was 14.93% in routine group respectively (P>0.05). Conclusion: Immunosuppressant combined with DFPP has a better effect in the treatment of severe lupus nephritis. It can effectively improve the liver-kidney function, regulate the immune level and accelerate the recovery of disease, and it has safety of medication and is recommended for clinical application.
万微波, 卢蓉, 熊蓉, 汪超阳, 范学朋, 胡述立. 双重血浆置换联合免疫抑制剂治疗重症狼疮性肾炎疗效及对外周血Alb BUN WBC水平的影响[J]. 河北医学, 2022, 28(1): 61-65.
WAN Weibo, LU Rong, XIONG Rong, et al. Efficacy of Double Filtration Plasmapheresis Combined with Immunosuppressant in the Treatment of Severe Lupus Nephritis and Its Influence on Levels of Peripheral Blood Alb BUN and WBC. HeBei Med, 2022, 28(1): 61-65.
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2022, Vol. 28 
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