PLASMA-EXCHANGE IN CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY
PLASMA-EXCHANGE IN CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY
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DOI：
10.1056/nejm198602203140801
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发表时间：
1986-02-20
影响因子：
158.5
通讯作者：
SWANSON, C
中科院分区：
文献类型：
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作者：
DYCK, PJ;DAUBE, J;SWANSON, C
据报道，血浆置换对慢性炎症性脱髓鞘性多发性神经根神经病有效。我们进行了一项前瞻性双盲试验，其中疾病稳定或恶化的患者被随机分配接受血浆置换（n = 15）或假交换（n = 14），为期三周。三周后，我们观察到神经传导（总传导、运动传导、近端传导、速度和振幅）的综合测量存在统计学显着差异，有利于接受血浆置换的患者。与接受假交换的任何患者相比，在 5 名患者的神经功能障碍评分（P = 0.025）和 4 名患者的无力和反射子集评分（P<0.057）中检测到了更大程度的改善。我们的结论是，对于一些慢性炎症性脱髓鞘性多发性神经根神经病患者，血浆置换对神经功能障碍和神经传导有改善作用，但在其他患者中没有观察到改善作用。由于血浆被正常血清白蛋白替代，因此一种或多种体液因素可能在这种疾病的神经功能缺损中发挥作用。 （新英格兰医学杂志 1986 年；314：461–5。）
Plasma exchange has been reported to be efficacious in chronic inflammatory demyelinating polyradiculoneuropathy. We performed a prospective double-blind trial in which patients with static or worsening disease were randomly assigned to plasma exchange (n = 15) or to sham exchange (n = 14) for three weeks. After three weeks, we observed statistically significant differences in combined measurements of nerve conduction (total, motor, proximal, velocity, and amplitude) favoring patients who had received plasma exchange. Improvement to a greater degree than for any patient receiving sham exchange was detected in the neurologic-disability score in five patients (P = 0.025) and in subset scores for weakness and reflex in four patients (P<0.057). We conclude that for some patients with chronic inflammatory demyelinating polyradiculoneuropathy, plasma exchange has an ameliorating effect on neurologic dysfunction and nerve conduction, but in others no improvement is observed. Because plasma was replaced with normal serum albumin, a humoral factor or factors may have a role in the neurologic deficit of this disorder. (N Engl J Med 1986; 314: 461–5.)