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四个全身性红斑狼疮(SLE)病人,因对皮质类固醇及免疫抑制剂治疗的效果不明显或不再进步而采用血浆换出治疗。其中两个病人有狼疮性肾炎伴肾功能衰竭,对以往强的松及环磷酰胺治疗效果很差。经分别换出665及1000ml血浆,再输注冷冻新鲜血浆或部分血浆、部分人白蛋白溶液后,临床进步非常显著,如皮疹及Raynaud现象完全消失,迅速利尿及水肿消退,血尿素氮降至正常或接近正常,蛋白尿明显减轻。以后用小剂量皮质类固醇及免疫抑制剂维持,在追踪观察的几个月和一年时间内,情况一直很好。另二个病人临床症状较轻,亦无严重肾脏损害的表现,对皮质类固醇及免疫抑制剂治疗有良好效应,但当药物剂量减少时症状又加重。血浆换出后(每人仅一次),残余的症状很快消失,以小剂量药物维持,情况亦良好。
Four systemic lupus erythematosus (SLE) patients, because of the effect of corticosteroids and immunosuppressive agents is not obvious or no improvement in the use of plasma exchange treatment. Two of these patients had lupus nephritis with renal failure, which was refractory to past prednisone and cyclophosphamide. After 665 and 1000 ml of plasma were swapped respectively, the clinical progress was very significant after the fresh plasma or some plasma and some human albumin solutions were transfused. For example, the rash and Raynaud phenomenon completely disappeared, the diuresis and edema subsided rapidly, and the blood urea nitrogen dropped to Normal or near normal, proteinuria significantly reduced. Later use of small doses of corticosteroids and immunosuppressive agents to maintain, tracking the observation of the months and one year, the situation has been good. The other two patients had less clinical symptoms and no signs of serious kidney damage. They had a good effect on the treatment of corticosteroids and immunosuppressive agents, but the symptoms worsened as the drug dose decreased. After the exchange of plasma (only once per person), the residual symptoms quickly disappear, with a small dose of drug maintenance, the situation is also good.