抗体阴性重症肌无力的短程血浆置换疗法初探

血浆置换(plasma exchange,PE)在重症肌无力(MG)上的疗效已有报道,但缺乏明确一致的置换方案。我们对12例MG患者进行了37人次的短程PE,各例均在10d内行3～4次置换术,术前和术后第7天按Mantegazza肌力评分表进行临床疗效评定,结果除1例外,均获得肯定疗效,仅1人次发生较严重的副反应。4例抗体阴性病人置换后均获显著疗效,提示抗体阴性MG血浆中存在某些未知的致病因子。短程PE可供选择作为MG危象的治疗方案。

A Short Plasma Exchange Protocol in Seronegative Myasthenia Gravis

Plasma Exchange (PE) has been reported to be a successful therapeutic procedure for the treatment of severely comprised myasthenic patients, but the optimal protocol has not been determined so far. We have investigated the efficacy of a short plasmapheresis protocol consisting of three to four exchanges within ten days in 12 patients with severe forms of myasthenia gravis (MG) . A positive outcome was observed in 11 patients, including 4 seronegative ones, which might suggest that a humoral factor is implicated in the pathogenesis of seronegative MG. Only in one case major side-effects were observed. We considered that a short PE protocol might have a position in the management of disabling MG, especially in the initial control of myasthenic crisis.