血浆置换对难治性类风湿性关节炎的治疗作用研究

目的:探讨血浆置换疗法对难治性类风湿性关节炎的治疗效果。方法:21例难治性类风湿性关节炎患者在常规药物治疗的基础上进行每周1次,共3次的血浆置换治疗,治疗过程中密切观察生命体征及不良反应。治疗前后患者免疫球蛋白、血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)的变化。结果:患者在经血浆置换治疗后16例(76.2%)患者晨僵时间缩短,15例(71.4%)患者乏力症状改善,13例(61.9%)患者关节肿胀和疼痛减轻;免疫学指标及炎性反应指标明显下降,治疗过程中不良反应发生率降低。结论:血浆置换术能有效治疗难治性类风湿性关节炎,且安全性高,临床上值得推广。

Study on the effect of plasma exchange on refractory rheumatoid arthritis

Objective To investigate the effect of plasma exchange treatment on rheumatoid arthritis.Method 21 patients with refractory rheumatoid arthritis were treated by plasma exchange(PE) on the basis of medication.The plasma exchange was performed once a week and totally 3 times for every patient.During the procedure,vital signs and adverse reactions of the patients were carefully observed.Serum immunoglobins,ESR,C reactive protein(CRP),and rheumatoid factor(RF) were detected before and after the treatment.Results After the treatment,16(76.2%) patients had shorter morning stiffness time,15(71.4%) patients could feel the improvement of fatigue,and 13(61.9%) patients felt the relief of joint swelling and pain.The immunological indexes and inflammation indexes of the patients were decreased obviously.Meanwhile,the treatment was performed with low complication rate.Conclusion Plasma exchange technique can effectively treat refractory rheumatoid arthritis and has good security.It is worthy of further widespread application in clinic.