Kiesewetter H, Blume J, Jung F, Gerhards M, Spitzer S, Leipnitz G, Wenzel E
Abteilung für Klinische Hämostaseologie und Transfusionsmedizin, Universitätskliniken des Saarlandes, Homburg.
Klin Wochenschr. 1988 Apr 1;66(7):284-91. doi: 10.1007/BF01727513.
The clinical effect of bag-plasmapheresis was investigated in 60 patients with peripheral arterial occlusive disease stage II according to Fontaine. The initial number of patients was subdivided in three groups of 20 individuals using a randomised double-blind placebo-controlled design. Each patient gave 300 ml of blood twice a week for a 6 week duration. Blood plasma was separated in two groups and replaced with Hydroxyethyl-starch (200/0.5 10%) in group 1 and with Laevulose 5% in group 2. Patients in group 3 received their whole blood without any processing. All patients had to undergo a physical training of 45 minutes three times a week. The group who received Hydroxyethylstarch presented a 20% increase in walking distance whereas the increase in the Laevulose group was 5% and approximately 1% in the group receiving whole blood. The increase in walking distance in the Hydroxyethylstarch-group was significant on the 0.1%-level and significantly better than the improvement in walking distance of the other groups. Additionally in this group plasma viscosity showed a 3% decrease, erythrocyte aggregation was reduced by 10%. Results in the Laevulose group were only half as good as in the Hydroxyethylstarch group while parameters remained unchanged in the whole-blood-group. Bag plasmapheresis with Hydroxyethylstarch as substitute leads to an improvement in the walking capacity and blood fluidity thus offering a promising therapy for peripheral vascular occlusive disease.
根据Fontaine分级标准,对60例II期外周动脉闭塞性疾病患者进行了袋式血浆置换的临床疗效研究。采用随机双盲安慰剂对照设计,将初始患者分为三组,每组20人。每位患者每周两次捐献300毫升血液,持续6周。将两组患者的血浆分离,第1组用羟乙基淀粉(200/0.5 10%)替代,第2组用5%果糖替代。第3组患者接受未经任何处理的全血。所有患者每周必须进行三次45分钟的体育锻炼。接受羟乙基淀粉的组步行距离增加了20%,而果糖组增加了5%,接受全血的组增加了约1%。羟乙基淀粉组步行距离的增加在0.1%水平上具有显著性,且明显优于其他组步行距离的改善。此外,该组血浆粘度降低了3%,红细胞聚集减少了10%。果糖组的结果仅为羟乙基淀粉组的一半,而全血组的参数保持不变。用羟乙基淀粉作为替代物进行袋式血浆置换可改善步行能力和血液流动性,从而为外周血管闭塞性疾病提供了一种有前景的治疗方法。