CSF filtration is an effective treatment of Guillain–Barré syndrome
CSF filtration is an effective treatment of Guillain–Barré syndrome
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DOI：
10.1212/wnl.57.5.774
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发表时间：
2001-01
期刊：
影响因子：
9.9
通讯作者：
K. Harum;Lily Alemi;Michael V. Johnston
中科院分区：
文献类型：
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作者：
K. Harum;Lily Alemi;Michael V. Johnston
目的：比较脑脊液滤过（CSFF）和血浆置换（PE）治疗格林-巴利综合征（GBS）的疗效。方法：在一项前瞻性对照临床试验中，37例急性GBS患者随机接受CSFF或PE治疗。入选标准是符合国家神经和交流障碍和中风标准研究所的要求，并且无辅助行走能力>5 m。结果如下：两组的基线特征相似（GBS研究组6分分级量表上的初始残疾等级），主要结局变量（随机化后28天内改善）几乎相同（等效性检验p = 0.0014），CSFF组的平均等级值为0.82，PE组为0.80。56天后，CSFF组的56%（16名患者中的9名）和PE组的37%（19名患者中的7名）达到2级（即，无辅助行走能力>5 m）。6个月后，两组达到2级的概率约为80%。在CSFF组中，发生了短暂的细胞增多，没有明显的临床并发症。PE治疗组的临床相关并发症更高。结论：虽然患者数量较少，但作者发现CSFF治疗GBS至少与PE一样有效。CSFF可能通过从CSF中清除炎症介质、自身抗体或其他因子而起作用。
Objective: To compare CSF filtration (CSFF) and plasma exchange (PE) in the treatment of patients with Guillain–Barré syndrome (GBS). Methods: In a prospective controlled clinical trial, 37 patients with acute GBS were randomized to receive either CSFF or PE. Inclusion criteria were fulfillment of National Institute of Neurological and Communicative Disorders and Stroke criteria and disability to walk >5 m unassisted. Results: With similar baseline features in both groups (initial disability grades on the six-point grading scale of the GBS Study Group) the primary outcome variable (improvement within 28 days after randomization) was almost identical (test for equivalence p = 0.0014), the mean grade values being 0.82 in the CSFF group and 0.80 in the PE group. After 56 days, 56% (9 of 16 patients) of the CSFF group and 37% (7 of 19 patients) of the PE group had reached grade 2 (i.e., ability of unassisted walking >5 m). After 6 months, the probability to reach grade 2 was about 80% in both groups. In the CSFF group, transient pleocytosis occurred without apparent clinical complications. Clinically relevant complications were higher in the PE-treated group. Conclusions: Although the number of patients was small, the authors found that the treatment of GBS with CSFF is at least as effective as with PE. CSFF might work by removing from the CSF inflammatory mediators, autoantibodies, or other factors.