Tazi I, Merimi F, Majd A, Benchemsi N
Centre Régional de Transfusion Sanguine, Casablanca, Morocco.
Transfus Apher Sci. 2008 Aug;39(1):45-8. doi: 10.1016/j.transci.2008.05.009. Epub 2008 Jun 25.
Therapeutic plasma exchange (TPE) is an extracorporeal blood purification method for the treatment of diseases in which pathological proteins have to be eliminated. In the aim to demonstrate our single center activity, we analyzed our data since 2 years.
Between years 2002 and 2005, 104 TPE procedures were performed on 42 patients. Median age and male/female ratio were 32 (range, 17-56) and 24/18, respectively. Departments those referred the majority of the TPE were neurology (n=32), nephrology (n=5) and intensive care unit (n=5). The most common indications were: polyradiculoneuropathies (53%), myasthenia gravis (17%) and Guillain-Barré syndrome (12%).
The median TPE procedure per patient was 2.3 (range, 1-10). In the majority of patients, vascular access was provided by puncture of two large, durable peripheral antecubital veins. The procedures were performed with the "Haemonetic Ultralight" discontinuous flow cell separator devices. Citrate solution was used as an anticoagulant in all cases. The substitution fluids most often used in our unit are Albumin 20% solution (92 times), Albumin 4% (10 times) and fresh frozen plasma (twice). Seventy five percent of the patients showed improvement, 7% remained the same and 18% worsened. Thirteen adverse reactions were recorded.
The creation of a national registry by the local society is a vital move to improve TPE practice in our country.
治疗性血浆置换（TPE）是一种体外血液净化方法，用于治疗必须清除病理性蛋白质的疾病。为了展示我们单中心的业务情况，我们分析了过去两年的数据。
2002年至2005年期间，对42例患者进行了104次TPE治疗。中位年龄和男女比例分别为32岁（范围17 - 56岁）和24/18。转诊进行大多数TPE治疗的科室是神经科（n = 32）、肾内科（n = 5）和重症监护病房（n = 5）。最常见的适应症为：多神经根神经病（53%）、重症肌无力（17%）和吉兰 - 巴雷综合征（12%）。
每位患者的TPE治疗中位次数为2.3次（范围1 - 10次）。大多数患者通过穿刺两条粗大、耐用的外周肘前静脉建立血管通路。治疗使用“Haemonetic Ultralight”间断流动细胞分离装置进行。所有病例均使用枸橼酸盐溶液作为抗凝剂。我们科室最常使用的置换液是20%白蛋白溶液（92次）、4%白蛋白（10次）和新鲜冰冻血浆（2次）。75%的患者病情改善，7%无变化，18%病情恶化。记录到13例不良反应。
当地学会建立全国性登记册是改善我国TPE实践的重要举措。
