Tharakan J, Jayaprakash P A, Iyer V P
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum.
J Assoc Physicians India. 1990 Aug;38(8):550-3.
The impact of small volume plasma exchange (PE) on the treatment of Guillain-Barre syndrome (GBS) was studied by comparing 25 patients treated with PE since 1982 with 25 historic controls treated without PE prior to 1982. Small volume PE was done by removing 10-15 ml plasma/kg body weight daily till the progression of the disease was arrested or recovery started. The PE group started recovering earlier (median 3 days, compared to 17.5 days in controls, 2P = 0.01), attained better clinical grades at the end of the 1st and 3rd months (2P = 0.001), and took much shorter time to recover by one clinical grade (median 15 days, compared to 53 days in controls, 2P = 0.01). The median duration of ventilation among the surviving patients was shorter in the PE group (8 days compared to 24.5 days, 2P = 0.10) and total number of complications was less in the PE group (15 events compared to 22 in the controls, 2P = 0.05). Three months after the onset of neuropathy, 13/25 controls were still bed bound, whereas only 4/25 in the PE group remained in that grade (2P = 0.02). There was no significant difference in the mortality rate in two groups (2P = 0.09), but the difference was significant in the subgroup of patients who were ventilated (2P = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
通过比较1982年以来接受小容量血浆置换（PE）治疗的25例吉兰 - 巴雷综合征（GBS）患者与1982年之前未接受PE治疗的25例历史对照患者，研究了小容量血浆置换对GBS治疗的影响。小容量血浆置换的做法是每天去除10 - 15 ml/千克体重的血浆，直到疾病进展停止或开始恢复。血浆置换组恢复得更早（中位数为3天，而对照组为17.5天，P = 0.01），在第1个月和第3个月末达到了更好的临床分级（P = 0.001），并且恢复一个临床分级所需的时间短得多（中位数为15天，而对照组为53天，P = 0.01）。存活患者中，血浆置换组的通气中位持续时间较短（8天，而对照组为24.5天，P = 0.10），并且血浆置换组的并发症总数较少（15起事件，而对照组为22起，P = 0.05）。神经病发作三个月后，13/25的对照组患者仍需卧床，而血浆置换组中只有4/25处于该分级（P = 0.02）。两组的死亡率没有显著差异（P = 0.09），但在需要通气的患者亚组中差异显著（P = 0.02）。（摘要截断于250字）
