关键词: 双重血浆置换,组合式,重症狼疮性肾炎,临床疗效,不良反应

Abstract: Ｏｂｊｅｃｔｉｖｅ：The study delves into the clinical efficacy and safety of centrifugalmembranous hybrid double filtration plasmapheresis (C／M hybrid DFPP) on severe lupus nephritis (LN) by comparing with membranous DFPP (M DFPP).
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective analysis was performed on 56 patients who were diagnosed with severe LN and had received DFPP treatment from May 2016 to January 2020.Clinical efficacy,vascular access,dosage of anticoagulant,treatment cost and adverse events were compared.
Ｒｅｓｕｌｔｓ：Of the 56 patients with severe LN (43 females and 13 males),SLEDAI was 186±60 and the median serum creatinine was 402(294,553) umol／L,51 of them (911％) required renal replacement therapy (RRT).A total of 142 DFPPs were performed,including 97 C／M hybrid DFPPs in 38 patients and 45 M DFPPs in 18 patients.ANA,AdsDNA titer,quantitative urinary protein and red blood cell,serum creatinine decreased significantly after DFPP.Three months after DFPP treatment,31 patients (608％) requiring RRT were released from dialysis,including 23 patients treated with C／M hybrid DFPP and 8 patients with M DFPP.The dosage of low molecular weight heparin (LMWH) and treatment costs were significantly lower in C／M hybrid DFPPs group(P<0001).Four patients (41％) in the C／M hybrid DFPP group developed perioral numbness,numbness in distal extremities or tetany during treatment,which was alleviated after calcium supplementation.
Ｃｏｎｃｌｕｓｉｏｎ：
Efficacy of C／M hybrid DFPP in treatment of severe LN was not differed from M DFPP,but with a lower dosage of LMWH and costs.

Key words: double filtration plasmapheresis, hybrid, severe lupus nephritis, clinical efficacyadverse events