目的 比较连续性血液净化(CBP)与间歇性血液净化(IHD)治疗重症狼疮性肾炎(SLN)患者的临床效果,探讨血液净化治疗SLN的最佳模式.方法 选取深圳市宝安区人民医院肾脏内科、风湿免疫科和重症医学科2012年1月至2016年4月收治的SLN患者48例,按随机数表法分为CBP组和IHD组,每组各24例,在常规激素联合环磷酰胺治疗基础上分别给予CBP和IHD治疗.对比分析两组患者在治疗1个月后的疗效、尿蛋白减少50％时间、血尿消失时间及血肌酐恢复时间.结果 治疗1个月后,与IHD组比较,CBP组的尿蛋白减少50％时间[(30.21±8.50)d vs(40.79±10.37)d]、血尿消失时间[(18.92±11.37)d vs(31.03±7.95)d)]及血肌酐恢复时间[(39.79±10.01)d vs(50.88±16.07)d]均明显缩短,差异均有统计学意义(P<0.05).CBP组有效率为91.7％,高于IHD组的66.7％,差异有统计学意义(P<0.05).结论 CBP治疗效果明显,可有效改善尿蛋白、血尿等症状,及时逆转肾功能,降低死亡率.%Objective To study the effectiveness of continuous blood purification (CBP) and intermittent blood purification (IHD) in treatment of patients with severe lupus nephritis. Methods A total of 48 patients with severe lu-pus nephritis admitted to Department of Critical Care Medicine, Department of Rheumatology and Immunology, Depart-ment of Nephrology in our hospital from January 2012 to April 2016 were randomly divided into a CBP group (n=24) and an IHD group (n=24) according to the random number table method. On the basis of combination therapy of conven-tional hormone with cyclophosphamide treatment, two groups were treated with CBP and IHD treatment, respectively. Comparison of two groups were explored on the clinical effects, the time for 50％reduction in urine protein, the time for the disappearance of hematuria and the time for recovery of serum creatinine at 1 month after treatment. Results The time required in CBP group were significantly shorter than those in IHD group for 50％ reduction in urine protein (30.21±8.50) d vs (40.79±10.37) d, for the disappearance of hematuria (18.92±11.37) d vs (31.03±7.95) d, and for recov-ery of serum creatinine (39.79 ± 10.01) d vs (50.88 ± 16.07). Total effective rate in CBP group was 91.7％, significantly higher than 66.7％in IHD group (P<0.05). Conclusion CBP therapy shows obvious effect, which can effectively im-prove the symptoms of urinary protein and hematuria, and timely reverse renal function and reduce mortality.
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