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血浆置换疗法在重症肌无力患者中的安全性。

Safety of plasma exchange therapy in patients with myasthenia gravis.

机构信息

Division of Neurology, University Health Network, University of Toronto, 5EC-309, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.

出版信息

Muscle Nerve. 2013 Apr;47(4):510-4. doi: 10.1002/mus.23626. Epub 2013 Jan 16.

Abstract

INTRODUCTION

Plasma exchange (PLEX) is effective in myasthenia gravis (MG), but there are concerns about its safety.

METHODS

We collected data prospectively from 42 patients randomized to PLEX treatment in a comparison study with intravenous immunoglobulin (IVIg). Detailed information on the PLEX treatment methodology and adverse events are reported.

RESULTS

Forty of 42 patients completed PLEX. Ninety percent were treated in an outpatient setting. Fifty-five percent had no complications, and 45% had mild-moderate reactions that did not require stopping treatment; the majority were citrate reactions and peripheral vascular issues that were easily treated. Fifty-seven percent of patients responded to treatment, and 83% completed PLEX via peripheral venous access. Two patients had severe adverse events: 1 related and 1 unrelated to PLEX. Comorbid disease and age did not predict reactions.

CONCLUSION

PLEX is safe, effective, and well tolerated in patients with MG. Our results do not raise concerns about the safety of PLEX in patients with moderate-severe MG.

摘要

简介

血浆置换(PLEX)在重症肌无力(MG)中有效,但人们对其安全性存在担忧。

方法

我们从 42 名随机接受 PLEX 治疗的患者中前瞻性地收集数据,这些患者在一项与静脉注射免疫球蛋白(IVIg)的对比研究中接受了治疗。详细报告了 PLEX 治疗方法和不良事件的信息。

结果

42 名患者中有 40 名完成了 PLEX 治疗。90%的患者在门诊接受治疗。55%的患者没有并发症,45%的患者出现轻度至中度反应,无需停止治疗;大多数是枸橼酸盐反应和外周血管问题,容易治疗。57%的患者对治疗有反应,83%的患者通过外周静脉通路完成了 PLEX。两名患者发生严重不良事件:1 例与 PLEX 相关,1 例与 PLEX 无关。合并症和年龄并不能预测反应。

结论

PLEX 在 MG 患者中安全、有效且耐受性良好。我们的结果并未对中重度 MG 患者接受 PLEX 治疗的安全性提出担忧。

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