Plasma exchange for severe attacks of inflammatory demyelinating diseases of the central nervous system
Plasma exchange for severe attacks of inflammatory demyelinating diseases of the central nervous system
复制标题
血浆置换治疗中枢神经系统炎症性脱髓鞘疾病的严重发作
DOI：
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发表时间：
2001
影响因子：
1.5
通讯作者：
B. Weinshenker
中科院分区：
文献类型：
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作者：
B. Weinshenker
血浆置换尚未被广泛接受为多发性硬化症的治疗方法。然而，一些不受控制的研究表明，严重发作的MS和其他炎症性脱髓鞘疾病患者在血浆交换治疗后可能会迅速改善。我们最近完成了一项随机、假对照、血浆置换的交叉临床试验，对22例中枢神经系统特发性炎症性脱髓鞘疾病患者进行了血浆置换。12人患有多发性硬化症，10人患有其他炎症性脱髓鞘疾病综合征。在每隔一天进行一次积极治疗的2周内，42%的患者经历了中度或更大程度的恢复，而只有6%的患者在接受假治疗时经历了类似的改善。3例假治疗失败的患者在转入积极治疗后病情迅速好转；积极治疗失败的患者在转入假手术治疗后均无好转。这项研究说明了设计随机临床试验的重要性，该试验是基于治疗方案和在非对照报告中研究的患者群体，这些报告表明了治疗效果。对于患有特发性炎症性脱髓鞘疾病综合征的患者，当皮质类固醇治疗失败时，应考虑血浆置换。j .中国。科学通报，2001,16:39‐42。©2001 Wiley‐Liss, Inc。
Plasma exchange has not been widely accepted as a treatment for multiple sclerosis. However, several uncontrolled studies have suggested that patients with severe attacks of MS and other inflammatory demyelinating disease may improve rapidly after plasma exchange treatment. We recently completed a randomized, sham‐controlled, crossover clinical trial of plasma exchange in 22 patients with idiopathic inflammatory demyelinating diseases of the central nervous system. Twelve had MS and ten had other inflammatory demyelinating disease syndromes. Forty‐two percent of patients experienced moderate or greater recovery over 2 weeks of active treatment administered every other day while only 6% of patients experienced similar improvement while receiving sham treatment. Three patients who failed the sham treatment subsequently improved rapidly after crossover to active treatment; no patient who failed active treatment improved after crossover to sham. This study illustrates the importance of designing randomized clinical trials based on the treatment regimen and patient population studied in the uncontrolled reports that suggested treatment efficacy. Plasma exchange should be considered for patients with idiopathic inflammatory demyelinating disease syndromes when they have failed corticosteroid therapy. J. Clin. Apheresis. 16:39‐42, 2001. © 2001 Wiley‐Liss, Inc.