双重滤过血浆置换治疗重症肌无力的研究

目的:探讨双重滤过血浆置换治疗重症肌无力的治疗方法及临床疗效、并发症的防治及应用价值。方法:全部病例使用日本Piasaulo IQ血浆置换装置,采用双重滤过血浆交换法,3 d置换一次,置换液为20%白蛋白50 mL加706代血浆1 000 mL。于置换前及置换后第5天清晨抽空腹血查AChR-AB,根据临床相对记分法判断临床疗效。结果:基本痊愈7例、显效11例、好转7例、无效3 例。治疗前后AChR-AB对比,P<0.05,总有效率89.33%。结论:双重滤过血浆置换能迅速清除血液中较高的AChR-AB,起效快,对治疗重症肌无力及抢救重症肌无力危象有重要的价值。

Study of Mysathenia Gravis Cured by Double Filtration Plasmapheresis

Aim: To discuss the therapeutic methods, clinical efficacy, prevention and cure of the complication, application value of the double filtration plasmapheresis (DFPP)in treating patients with mysathenia gravis(MG) . Methods: The exchange equipment of Piasaulo IQ of plasma was used in all the cases.The double filtration plasmaphersis was performed every 3 days and the exchanging liquid was composed of 50 mL of 20% albumen and 1 000 mL of 706 plasma substitute. Physical examination for relative lclinical score and with drawal blood for AChR-AB determination were done early in the morning before the day of DFPP and the fifth day since DFPP. Results: The numbers of patients in therapeutis were assessed by grades: cure, essential cure, remarked effect,effect and no effect was 0,6,11,7 and 3 respectively.The concentration of the serum AChR-AB was decreased significantly after DFPP (P <0.05) ,and total effective rate was 89.93% . Conclusion:DFPP could clear away the higher level AChR-AB in blood quickly,and it was essentially valuable in the therapy and emergent treatment of MG crises.