血浆置换联合激素治疗重症神经系统脱髓鞘疾病

目的　评价血浆置换联合激素治疗重症吉兰 -巴雷综合征 ( Guillain-Barre syndrome,GBS)和多发性硬化( multiple sclerosis,MS)的临床疗效。方法　回顾性分析血浆置换联合激素治疗的 1 3例重症 GBS和 7例重症MS的临床转归及治疗后血中免疫球蛋白滴度变化。结果　患者呼吸肌麻痹于治疗后 5～ 1 4d缓解 ,2个月内临床表现缓解率分别为 GBS76.9% ,MS5 7.1 %。血中免疫球蛋白滴度明显减少 ( P <0 .0 1 )。结论　血浆置换联合激素疗法疗效肯定 ,可作为治疗急性重症神经脱髓鞘疾病首选方法。

The Combined of Plasma Exchange and Glucocorticoid Treatment for Patients with Severe Neurologic Demyelinating Diseases

Objective To evaluate the clinical efficacy of plasma exchange (PE) combined with glucocorticoid treatment to severe patients with Guillain-Barre syndrome (GBS)and multiple sclerosis(MS). Methods The correlation between clinical presentation and serum immunoglobulin was analyzed retrospectively in 13 GBS and 7 MS before and after treatment. Results The improvement of respiratory muscle weakness occurred at 5-14 days after treatment. In two months after the therapy,the patients recovery rate with GBS and MS was 76.9% and 57.1% respectively. The concentration of the serum immunoglobulin was significantly decreased after treatment (P<0.01). Conclusions PE combined with glucocorticoid therapy is effective and recommended as the best choice in the treatment of acute and severe neurologic demyelinating diseases.