Plasma exchange treatment improves prognosis of antineutrophil cytoplasmic antibody-associated crescentic glomerulonephritis: a case-control study in 26 patients from a single center

Twenty-six patients with Antineutrophil cytoplasmic antibody (ANCA)-associated crescentic glomerulonephritis (GN) were divided into two groups according to the acute phase treatment: drug therapy consisting of steroids and oral cyclophosphamide plus a plasma exchange (PE) course (group A, 13 patients) or drug therapy alone (group B, 13 patients). Group A patients had a more severe clinical picture and higher serum creatinine than group B (12.7 +/- 6.9 vs. 8.5 +/- 5.3 mg%); nine patients from group A (69%) and five from group B (38%) required dialysis. At follow up (mean 35 months) all patients treated with PE were alive: four of them were in end-stage renal disease. Among group B patients, three (23%) died in the acute phase; 6 (46%) needed renal replacement therapy at follow up. Of the dialysis-dependent patients, five out of nine from group A were free of dialysis, while in group B two out of five patients had died, two had entered a regular dialysis treatment and one had received a cadaver graft. These data suggest that PE may significantly improve the prognosis of patients with ANCA-associated crescentic GN even if they are not dialysis-dependent at the time of diagnosis.     

血浆置换疗法在皮肤病中的应用

血浆置换疗法 ( ｐｌａｓｍａｅｘｃｈａｎｇｅ ,ＰＥ)是一种体外净化 (ａｐｈｅｒｅｓｉｓ)方法 ,通过血细胞分离机、分离膜等去除血浆中的致病因子 ,如特异性自身抗体、参与组织损伤的非特异性炎症介质 (补体、Ｃ反应蛋白、纤维蛋白原等 )、免疫复合物、胆固醇、巨球蛋白、毒性代谢产物、微生物及其代谢产物等 ,同时补充适量的正常人血浆、白蛋白或代血浆 ,从而发挥治疗作用。血浆去除术 ( ｐｌａｓｍａｐｈｅｒｅｓｉｓ)系指通过在体外去除血浆来治疗疾病的方法。目前ＰＥ和血浆去除术已被作为同义词使用。1914年 ,美国Ｈｏｐｋｉｎｓ大…     

Plasma exchange in systemic lupus erythematosus.

Eight out of 10 patients studied longitudinally received benefit from plasmapheresis. The patients were used as their own controls, being treated in a steady state as far as was possible. Levels of circulating complexes did not bear a close relationship with clinical results. On the evidence plasma exchange alone does not appear to represent an important part of the long-term management of patients with systemic lupus erythematosus but may well be of value in combination with other therapy.     

血浆置换在治疗肾脏病中应用的进展

血浆置换 (ｐｌａｓｍａｅｘｃｈａｎｇｅ,ｐｌａｓｍａｐｈｅｒｅｓｉｓ)就是将患者的血浆分离后弃去 ,然后将去除血浆的血液有形成分以及所需补充的血浆或其替代品输回体内 ,以清除患者血浆内的致病物质 ,以达到治疗目的。1　血浆置换的方法膜式分离法是目前较常采用的方法。主要用一个血浆滤过器 ,通过滤过器微孔将血浆分离出来。本法较以前的离心分离法更为简便 ,且可连续进行。近年有许多更为复杂的技术运用于血浆置换 ,这样能高度选择地清除循环中的致病物质。例如 :冷滤过法 (采用冷冻血浆的技术 ) ,免疫吸附技术 (采用已含有配体的…     

血浆置换疗法在家族性高胆固醇血症中的应用

家族性高胆固醇血症 (ＦＨ)是由于低密度脂蛋白 (ＬＤＬ)受体基因突变所致的常染色体显性遗传性疾病 ,分为纯合子型和杂合子型。纯合子型其外周组织细胞表面的ＬＤＬ受体严重缺乏 ,杂合子型部分缺乏 ,导致ＬＤＬ受体缺陷 ,引起血浆ＬＤＬ分解代谢障碍 ,从而使富含胆固醇的ＬＤＬ生成增加和清除障碍。其主要临床表现为高胆固醇血症 ,纯合子患者可达 15 6ｍｍｏｌ/Ｌ( 60 0ｍｇ/ｄｌ)以上 ,杂合子患者可达正常人的 2倍以上 ;伴有特征性的黄色瘤 ,常在早年死于冠心病、心肌梗死[1] 。因其病因特殊 ,一般降脂药物多难奏效 ,而具有一定疗效的回肠…