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目的 :探讨采用静脉滴注免疫球蛋白 (IVIG)治疗狼疮性肾炎 (LN)并发感染的疗效及适应证。方法 :13例LN并发感染患者 ,采用IVIG 4 0 0mg/ (kg·d) ,连用 3～ 5d ,此后给予泼尼松 (pred) 1mg/ (kg·d) ,4周后 ,按系统性红斑狼疮活动指数比较治疗前后病情控制情况、2 4h尿蛋白、尿红细胞数、C3 、C4、抗ds DNA抗体、血小板数以及抗核抗体。结果 :IVIG治疗 4周后 ,13例肺部感染全部治愈 ,上述指标于治疗前、后均有显著或非常显著差异 (P <0 .0 5或P <0 .0 1) ,5 / 13例ANA转阴性。结论 :IVIG联合 pred治疗LN并发感染是一有效治疗措施 ,尤其对LN并发感染并有血小板明显减少、体质差 ,暂时无法使用大剂量甲泼尼龙及 /或免疫抑制剂治疗的患者更为适宜
Objective: To investigate the efficacy and indications of intravenous immunoglobulin (IVIG) in the treatment of complicated infection of lupus nephritis (LN). Methods: Thirteen cases of LN complicated with infection were treated with IVIG 400 mg / (kg · d) for 3 ~ 5 days, then prednisone (1 mg / (kg · d)) was administrated. After 4 weeks, systemic erythema Lupus activity index before and after treatment to control the condition, 24 h urinary protein, urinary red blood cell count, C3, C4, anti-ds DNA antibody, platelet count and anti-nuclear antibody. Results: After 4 weeks of IVIG treatment, 13 cases of pulmonary infection were completely cured. There was significant or very significant difference (P <0.05 or P <0.01) before and after treatment, 5/13 cases ANA negative. Conclusions: The combination of IVIG and pred in the treatment of LN complicated infection is an effective treatment. Especially for LN complicated with obvious reduction of platelets, patients with poor physique, temporarily unable to use large doses of methylprednisolone and / or immunosuppressive agents are more suitable