双重血浆置换与血浆吸附治疗自身免疫性疾病的比较研究.pdf

广东医学20l2年5月第33卷第9期GuangdongMedicaljournalMay.20l2aVoI.33aNo.9932l

双重血浆置换与血浆吸附治疗自身免疫性
疾病的比较研究!

刘新宇,王晓红,黄敏,李永强,李宾,张漠,邹和群#
甫方医科大学第三附属医院x内科!广州5l0630"

!摘要"目的比较双重血浆置换(DFPP)和血浆吸附(PA)两种血浆净化方式治疗自身兔疫性疾病的差
异O方法30例自身兔疫性疾病患者分为两组,分别采用DFPP和PA进行治疗,对单次治疗前后IgA~IgG~IgM~

C3~C4指标及血液净化相关并发症情况进行比较O结果单次DFPP治疗后血清IgA~IgG~IgM~C3~C4水平下降比
率分别为(44.21l4.0)%~(45.216.3)%~(49.31l3.l)%~(46.21l0.3)%~(44.01ll.6)%,单次PA治疗后

血清IgA~IgG~IgM~C3~C4水平下降比率分别为(42.418.5)%~(42.916.2)%~(46.l17.2)%~(42.516.5)%~

(48.319.6)%;单次DFPP与PA在相同治疗量下对血清IgA~IgG~IgM~C3~C4的清除效果差异无统计学意义,但
PA的血液净化相关并发症发生率比DFPP吏低(P<0.05)O结论自身兔疫性疾病行DFPP及PA治疗均可以有
效地清除血清兔疫球蛋白和补体且两者清除效果相当,但PA治疗的并发症发生率吏低O
!关键词"双重血浆置换;血浆吸附;自身兔疫性疾病

Comparativestudyofdouble-filtrationplasmapheresisandplasmaadsorptionintreatmentofautoimmunedisea-
ses.LIUxin-yu,WANGxiao-hong,HUANGmin,LIyong-giang,LIbin,ZHANGying,ZOUH-gun.Dpart-
mntofNphrology,thThirdAffiliatdHospitalofsouthrnmdiCalUniUrsity,Guangzhou5l0630,China
Corrspondingauthor:ZOUH-gun.E-mail:[e-mail]
AbstractObjectiveTocomparetheeFFicacyoFDoubIe-FiItrationpIasmapheresis(DFPP)anDpIasmaabsorp-
tion(PA)inthetreatmentoFautoimmuneDiseases.MethodsThirtypatientswithautoimmuneDiseaseswereDiviDeDin-

totwogroups,inwhichtheyweretreateDwithDFPPanDPArespectiveIy.TheserumIgA,IgG,IgM,C3anDC4IeveIs

anDbIooDpuriFicationassociateDcompIicationswerecompareD.ResultsThereDuctionoFIgA,IgG,IgM,C3anDC4aF-
terDFPPwere(44.21l4.0)%,(45.216.3)%,(49.31l3.l)%,(46.21l0.3)%anD(44.01ll.6)%,re-
spectiveIy;anDwere(42.418.5)%,(42.916.2)%,(46.l17.2)%,(42.516.5)%anD(48.319.6)%,re-

spectiveIyaFterPA.TherewasnosigniFicantDiFFerenceinthecIearanceratesoFIgA,IgG,IgM,C3orC4betweenDFPP
anDPAwithsameDosage.However,signiFicantIyIowerinciDenceoFbIooDpuriFicationassociateDcompIicationswasre-
veaIeDinPAtreatmentthanDFPP(P<0.05).ConclusionItissuggesteDthatDFPPanDPAcaneFFectiveIyremovese-
rumimmunogIobuIinsanDcompIementsintreatingautoimmuneDiseases,witheguaIcIearancerates,butPAtreatment
guaranteesIowerinciDenceoFbIooDpuriFicationassociateDcompIications.