环孢菌素a联合血浆置换治疗急性重症狼疮肾炎（Cyclosporine a combined plasma exchange in the treatment of acute severe lupus nephritis）.docVIP

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环孢菌素a联合血浆置换治疗急性重症狼疮肾炎（Cyclosporine a combined plasma exchange in the treatment of acute severe lupus nephritis）.doc

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环孢菌素a联合血浆置换治疗急性重症狼疮肾炎（Cyclosporine a combined plasma exchange in the treatment of acute severe lupus nephritis）

环孢菌素a联合血浆置换治疗急性重症狼疮肾炎（Cyclosporine a combined plasma exchange in the treatment of acute severe lupus nephritis） Cyclosporine A combined plasma exchange in the treatment of acute severe lupus nephritis 2011-01-16 Liu Weiguo, Peng Bao, Li Xionggen Often patients with acute severe lupus nephritis with severe infection, white blood cell is low, cannot tolerate high-dose immunosuppressive therapy, we use cyclosporine A (cyclosporin A CsA) combined with plasma exchange (PE) in treatment of acute severe lupus nephritis and achieved a good result, report as follows now. 1 data and methods 1.1 subjects: 41 hospitalized patients with acute severe lupus nephritis, including 4 males and 37 females, aged 21~45 years, with an average of (26 + 10) years, and the duration of disease ranged from 3 months to 2 years. All the patients were consistent with the 1982 American College of Rheumatology diagnostic criteria, clinical symptoms are severe, with renal impairment, antinuclear antibody (ANA) and anti double stranded DNA (AdsDNA) antibody titer, severe increase of complement C3, C4 value of severe decline. Treatment methods: 1.2 patients were divided into two groups, 19 cases in the treatment group: 3 CsA - 5 mg.kg - 1.d - 1 oral drug trough blood concentration in 80 ~ 200 g/ml (HPLC); Prednisone 0.3 ~ 0.5 mg.kg 1.d 1 with PE in the acute period; and using FreseniusP2S, plasma separator (Germany), PHX 2100 hemodialysis machine (Japan kawazumi), plus a blood pump to supplement the replacement fluid. The surface of large vein leads, transfusion of blood, manual monitoring equilibrium plasma exchange volume, adjust the plasma filtration speed is about 30 ml/min, with 5% albumin saline replacement fluid replacement, each 2000 ~ 3000 ml, 1 to 3 times a week, for the first 3 to 7 times, depending on the situation after coupled with PE. The control group of 22 cases: prednisone 1 mg.kg - 1.d - 1, the acute phase with methylprednisolone (1 g/d intravenously for 3 D for a course of treatmen