自动红细胞置换输血：用于治疗脑型疟疾。

Automated RBC exchange transfusion:treatment for cerebral malaria.

作者信息

Weir E G, King K E, Ness P M, Eshleman S H

机构信息

Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA.

出版信息

Transfusion. 2000 Jun;40(6):702-7. doi: 10.1046/j.1537-2995.2000.40060702.x.

DOI:10.1046/j.1537-2995.2000.40060702.x

PMID:10864992

Abstract

BACKGROUND

Cerebral malaria is a life-threatening complication of Plasmodium falciparum infection. RBC exchange transfusion can reduce the level of parasitemia in this setting. Experience with automated RBC exchange for cerebral malaria may be limited, as most cases occur when the necessary equipment and blood components are not readily available.

CASE REPORTS

Three patients were admitted with cerebral malaria. Parasites were found in more than 30 percent of RBCs in two cases and in more than 60 percent of RBCs in the third case. Many RBCs contained multiple organisms. In each case, antimalarial therapy was begun, and an automated RBC exchange was performed emergently with a cell separator. Exchange transfusion was repeated within 24 hours for two patients. Parasitemia levels were less than 1 percent in all patients 24 hours after the last exchange. The neurologic status of these patients returned to baseline, and they were discharged 7 to 18 days after admission.

CONCLUSION

Automated RBC exchange transfusion can rapidly reduce the level of parasitemia and restore neurologic functioning in patients with cerebral malaria.

摘要

背景

脑型疟疾是恶性疟原虫感染的一种危及生命的并发症。在这种情况下，红细胞置换输血可降低疟原虫血症水平。由于大多数脑型疟疾病例发生时必要的设备和血液成分不易获得，因此自动红细胞置换治疗脑型疟疾的经验可能有限。

病例报告

三名患者因脑型疟疾入院。两例患者超过30%的红细胞中发现疟原虫，第三例患者超过60%的红细胞中发现疟原虫。许多红细胞含有多个疟原虫。在每例病例中，均开始进行抗疟治疗，并使用血细胞分离机紧急进行自动红细胞置换。两名患者在24小时内重复进行了置换输血。最后一次置换后24小时，所有患者的疟原虫血症水平均低于1%。这些患者的神经功能恢复至基线水平，入院后7至18天出院。