Donofrio P D, Tandan R, Albers J W
Department of Neurology, University of Michigan, Ann Arbor, Ml 48109-0010, USA.
Muscle Nerve. 1985 May;8(4):321-7. doi: 10.1002/mus.880080409.
Eleven consecutive patients with progressive chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) underwent plasma exchange. Eight patients were previously unresponsive to prednisone, two were started on prednisone with plasma exchange, and one did not receive corticosteroids. Electrodiagnostic studies revealed evidence of an acquired demyelinating polyradiculoneuropathy with varying degrees of axonal degeneration. Neurologic impairment was monitored using conventional functional status index. Five patients demonstrated substantial clinical improvement, beginning 2 days to 3 weeks after initiating plasma exchange. Two additional patients improved following a second course of plasma exchange, and four patients demonstrated minimal or no change. Comparison of responding and nonresponding patients showed no differences related to the presence or absence of antecedent illness, duration of disease, duration of maximum weakness, or severity of impairment prior to plasma exchange. Responders had significantly prolonged F-response and motor distal latencies compared to nonresponders. Results in this unselected, consecutive patient trial suggest a temporal relationship between plasma exchange and clinical improvement in some patients with progressive CIDP.
11例连续性进行性慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）患者接受了血浆置换。8例患者先前对泼尼松无反应，2例在进行血浆置换时开始使用泼尼松，1例未接受皮质类固醇治疗。电诊断研究显示存在获得性脱髓鞘性多发性神经根神经病，并伴有不同程度的轴突变性。使用传统功能状态指数监测神经功能损害。5例患者在开始血浆置换后2天至3周出现明显临床改善。另外2例患者在第二个疗程的血浆置换后病情改善，4例患者显示出最小变化或无变化。有反应和无反应患者的比较显示，在血浆置换前是否存在前驱疾病、病程、最大无力持续时间或损害严重程度方面无差异。与无反应者相比，有反应者的F波反应和运动远端潜伏期显著延长。在这项未经选择的连续性患者试验中，结果表明血浆置换与部分进行性CIDP患者的临床改善之间存在时间关系。
