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1.
本文介绍了以贝朗Diapact CRRT原有治疗模式为基础.结合该机只用一个称重系统保持液体平衡的设计特点,实现双重血浆置换新功能的原理、方法和临床应用。 相似文献
2.
Kawashima A 《Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy》2003,7(4):413-418
Low-density lipoprotein (LDL) apheresis is performed in patients with homozygous familial hyper-cholesterolemia who lack LDL receptors and with heterozygous familial hypercholesterolemia who are LDL receptor deficient with documented, symptomatic coronary artery disease who are resistant to diet changes and maximum drug therapy. LDL apheresis can reduce or abolish anginal symptoms and improve coronary lesions. Several reports reveal the improvement of insufficient peripheral blood flow. By extensively removing blood LDL and changing coagulation factors and various vasoactive substances, LDL apheresis improves blood rheology and thereby peripheral circulation. It seems worth trying on all patients with arteriosclerotic lesions, even if they are normocholesterolemic. 相似文献
3.
二重滤过血浆置换治疗难治性高脂血症 总被引:2,自引:0,他引:2
目的 了解单次二重滤过血浆置换治疗非家族性、难治性高脂血症的短期疗效。方法 2 0例非家族性高脂血症患者接受二重滤过血浆置换疗法 ,其中 14例患者治疗前血浆总胆固醇 (TC)大于6 .8mmol/L或甘油三脂 (TG)大于 2mmol/L ,低密度脂蛋白 (LDL)水平均高于 3.1mmol/L。取治疗前和治疗结束时的血样 ,分别测量血浆TC、TG、LDL、Apo(A)、Apo(B)、Lp(a)、HDL和纤维蛋白原水平。 结果11例患者具有完整的记录 ,其平均年龄 (4 5 .2 5± 8.33) (2 6~ 5 9)岁 ;平均病程为 6 .7年。单次治疗总置换量为 (4 183± 6 6 7) (30 0 0~ 5 0 0 0 )ml,治疗前后TC、TG、LDL、Apo(A)、Apo(B)、Lp(a)、HDL和纤维蛋白原水平分别为 (6 .86± 1.17)mmol/Lvs (3.4 2± 0 .6 3)mmol/L、(3.92± 2 .13)mmol/Lvs (3.5 7± 1.82 )mmol/L、(4 .0 3± 0 .86 )mmol/Lvs (1.13± 0 .6 6 )mmol/L、(1.34± 0 .37)g/Lvs (0 .85± 0 .30 )g/L、(1.34± 0 .5 7)g/Lvs (0 .70± 0 .34)g/L、(176 .14± 75 .5 3)mg/Lvs (98.4 3± 4 4 .0 8)mg/L、(1.0 3± 0 .2 8)mmol/Lvs (0 .6 8±0 .2 2 )mmol/L、(2 6 3.6± 86 .4 9)mg/dlvs (15 4 .88± 4 4 .12 )mg/dl。TC平均下降 5 1% ;LDL下降约 72 % ;Apo(a)和Apo(b)分别下降 32 %和 4 4 %左右。Lp(a 相似文献
4.
双重滤过血浆置换治疗强直性脊柱炎13例 总被引:6,自引:0,他引:6
强直性脊柱炎至今缺少有效疗法,为了改善治疗现状,本文应用双重滤过血浆置换方法.方法:选择经药物和理疗治疗无效的13例患者(男12例,女1例);其中有骶髂关节炎X线表现者12例,做过HLA-BB27检查的8例均为阳性.在平均13.1±8.3天的时间里,进行了1~5次的血浆置换治疗.依病人功能从日常活动不受限制到完全失去日常功能分为1~4级.结果:治疗结束时功能改善1级7例,2级4例,无改善2例;血沉由治疗前45.3±26.5mm/h降至治疗后26.8±21.0mm/h.研究结果表明双重滤过血浆置换疗法对强直性脊柱炎有相当的疗效,同时也提示免疫功能紊乱可能参与发病过程. 相似文献
5.
《Modern rheumatology / the Japan Rheumatism Association》2013,23(4):357-361
AbstractPulmonary hemorrhage (PH) is a rare but fatal complication of systemic lupus erythematosus (SLE). We report a patient with SLE and a massive PH who was treated with double-filtration plasmapheresis synchronized with cyclophosphamide pulsed therapy. The patient showed dramatic improvement immediately and was followed for 3 years without recurrence. Prompt treatment during the acute phase of PH with this short-term intensive combination therapy may offer the best chance of success. There are few reports of long-term followup, especially in Japan. 相似文献
6.
Patients undergoing ABO-incompatible kidney transplantation must have their anti-donor blood-type antibody titer (ADBT) reduced to below 1:16 by using either plasma-exchange (PEX) or double filtration plasma exchange (DFPP) before they can safely undergo a transplantation. The ADBT can be reduced to under 1:16 in most cases; however, some cases (non-responders) do not respond to PEX or DFPP treatment. To enable kidney transplantations to be performed in non-responders, we developed a new preconditioning regimen consisting of anti-CD20 monoclonal antibody (rituximab) infusions, a splenectomy, and DFPP. Four non-responders were infused with rituximab at a dose of 375 mg/m(2) weekly for 3-4 wk and splenectomized 1 or 2 wk before transplantation. Four to five DFPP-sessions were then performed after the splenectomy. Using this preconditioning regimen, the ADBT was reduced to below 1:16, enabling kidney transplantations to be successfully performed in all patients. After the kidney transplantation, no episodes of humoral rejection were observed, and only one episode of cellular rejection was encountered. The cellular rejection was associated with a reduction in immunosuppressant administration because of CMV infection that occurred 80 d after the kidney transplantation. The renal allografts were functioning well in all patients after a mean follow-up period of 390 d. No serious complications or side effects were encountered. We have developed a new preconditioning regimen that enables PEX and DFPP non-responders to undergo ABO-incompatible kidney transplantations. 相似文献
7.
T. Ito K. Inose S. Horie Y. Okubo R. Yoshida K. Nakazawa K. Nakada 《Modern rheumatology / the Japan Rheumatism Association》2002,12(4):0357-0361
Pulmonary hemorrhage (PH) is a rare but fatal complication of systemic lupus erythematosus (SLE). We report a patient with
SLE and a massive PH who was treated with double-filtration plasmapheresis synchronized with cyclophosphamide pulsed therapy.
The patient showed dramatic improvement immediately and was followed for 3 years without recurrence. Prompt treatment during
the acute phase of PH with this short-term intensive combination therapy may offer the best chance of success. There are few
reports of long-term followup, especially in Japan.
Received: February 12, 2002 / Accepted: May 28, 2002
Correspondence to:K. Inose 相似文献
8.
Shigeyoshi Yamanaga Yoshihiko Watarai Takayuki Yamamoto Makoto Tsujita Takahisa Hiramitsu Koji Nanmoku Norihiko Goto Asami Takeda Kunio Morozumi Akio Katayama Hiroh Saji Kazuharu Uchida Takaaki Kobayashi 《Human immunology》2013
Although short-term graft survival has been improved by recent desensitization protocols including B cell depletion therapy, little is known about risk factors of chronic antibody-mediated rejection (CAMR) in HLA-incompatible (HLA-I) renal transplantation (RTx). Twenty-six HLA-I RTx with positive donor-specific antibodies (DSA) and negative T cell cytotoxic crossmatches were compared with 88 ABO-incompatible (ABO-I) and 207 ABO-identical/compatible (ABO-Id/C) RTx. The desensitization therapy consisted of mycophenolate mofetil, rituximab and double-filtration plasmapheresis. Protocol biopsies within 1 year revealed subclinical CAMR in 36% of HLA-I, 5% of ABO-I and 3% of ABO-Id/C, although clinical acute AMR was observed in 8%, 3% and 1%, respectively. The incidence of CAMR was not different between class I and class II DSA. Most of class I DSA (94%) changed to negative 1 year after RTx, whereas 77% of class II DSA remained positive. In addition, the remaining DRB ± DQB DSA caused CAMR in 80% of patients, while DQB DSA alone did not. The progress of subclinical CAMR within 1 year could not be circumvented by rituximab. Sustained class II (DRB ± DQB) DSA detection after RTx may pose a potential risk for developing CAMR, but negative change in class I DSA could also elicit CAMR. 相似文献
9.
Double-filtration plasmapheresis for resolution of corticosteroid resistant adult onset still's disease 总被引:3,自引:0,他引:3
A 45-year-old Japanese male was diagnosed with adult onset Still's disease (AOSD). High-dose corticosteroid initially resolved the illness; however, high fever, maculopalpular rashes, arthralgia, and acute pericarditis rapidly recurred, and were followed by a somnolent state without focal signs. A diagnosis of corticosteroid resistant, severe, recurrent AOSD was made, and double-filtration plasmapheresis (DFPP) was performed immediately. The somnolent state began to resolve during the first plasmapheresis procedure, and the other symptoms resolved shortly thereafter. DFPP theoretically removes monocyte-activating cytokines, such as monocyte colony-stimulating factor (M-CSF) from the circulation, and therefore may prove to be an effective treatment for corticosteroid resistant, rapidly developing cases of AOSD. 相似文献
10.
A case of Wegener’s granulomatosis with pulmonary bleeding successfully treated with double filtration plasmapheresis (DFPP) 总被引:1,自引:0,他引:1
Iwatani H Uzu T Kakihara M Nakayama Y Kanasaki K Yamato M Hirai Y Umimoto K Yamauchi A 《Clinical and experimental nephrology》2004,8(4):369-374
We report a case of a 41-year-old Japanese man who presented with rapidly progressive glomerulonephritis, chronic sinusitis, and positive cytoplasmic-antineutrophil cytoplasmic antibody (c-ANCA). Renal biopsy showed crescentic glomerulonephritis, and he was diagnosed as having Wegeners granulomatosis. During the clinical course, he suffered from pulmonary bleeding, and combination therapy of steroid, immunosuppressant, and double filtration plasmapheresis (DFPP) was started. He rapidly entered remission after assistance through DFPP, suggesting the potential efficacy of DFPP for Wegeners granulomatosis, especially with pulmonary bleeding. 相似文献