Surrenti C, Pozzi M, Biagini M R, Franco C, Lombardo R, Avanzi G
Department of Clinical Pathophysiology, University of Florence, Italy.
Hepatogastroenterology. 1990 Feb;37(1):128-30.
Six patients were studied to evaluate the efficacy and safety of plasma exchange (PE) in the treatment of primary biliary cirrhosis (PBC). All patients were affected by PBC at stage III-IV and presented symptoms refractory to pharmacologic therapy. Patients underwent PE for a mean period of 40 weeks (range 10-88). A mean of 33 liters (range 17-64) of plasma per patients was removed. Patients reported less fatigue (4/6), pruritus (5/5), nausea (3/3), Sjogren's syndrome (2/6), and painful neuropathy (2/3). A reduction of xanthomata was noted in one of the three affected patients. Definitive improvement was seen in the patient with Raynaud's phenomenon. A significant reduction was noted for serum cholesterol and gammaglobulins. ALT, AST, gamma-GT, alkaline phosphatase, bilirubin, prothrombin activity, AMA titers were not affected by PE. All patients suffered some mild adverse effects during PE. Two patients (IV stage) developed late edema and ascites after 34 and 44 weeks of treatment. We conclude that PE can be considered effective chronic treatment for advanced symptomatic PBC refractory to pharmacological therapy.
对6例患者进行了研究，以评估血浆置换（PE）治疗原发性胆汁性肝硬化（PBC）的疗效和安全性。所有患者均处于PBC III-IV期，且对药物治疗的症状难治。患者接受PE的平均时间为40周（范围10-88周）。每位患者平均去除33升（范围17-64升）血浆。患者报告疲劳减轻（4/6）、瘙痒减轻（5/5）、恶心减轻（3/3）、干燥综合征减轻（2/6）、疼痛性神经病变减轻（2/3）。3例受累患者中有1例黄瘤减少。雷诺现象患者有明确改善。血清胆固醇和γ球蛋白显著降低。谷丙转氨酶（ALT）、谷草转氨酶（AST）、γ-谷氨酰转肽酶（γ-GT）、碱性磷酸酶、胆红素、凝血酶原活性、抗线粒体抗体（AMA）滴度不受PE影响。所有患者在PE期间均出现一些轻微不良反应。2例患者（IV期）在治疗34周和44周后出现晚期水肿和腹水。我们得出结论，对于对药物治疗难治的晚期有症状PBC，PE可被视为有效的慢性治疗方法。
