Matsuo H, Nakamura T, Tsujihata M, Kinoshita I, Satoh A, Tomita I, Shirabe S, Shibayama K, Nagataki S
First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Lancet. 1988 Nov 12;2(8620):1109-13. doi: 10.1016/s0140-6736(88)90525-9.
In 11 of 18 patients with human T-lymphotropic virus type-I (HTLV-I) associated myelopathy (HAM) gait, sensory, and/or sphincter disturbance improved with plasmapheresis (4 to 6 sessions in 2 weeks), and the effects were maintained for 2 to 4 weeks. Plasmapheresis lowered the titre of HTLV-I antibody in serum but not in cerebrospinal fluid, and change of HTLV-I antibody titres did not correlate with the effects of plasmapheresis. These results suggest that plasmapheresis is useful treatment, at least in producing a temporary improvement, in patients with HAM, and that some humoral factor(s), but not HTLV-I antibody, may be important in the pathogenesis of HAM.
在18例I型人类嗜T淋巴细胞病毒（HTLV-I）相关脊髓病（HAM）患者中，11例患者的步态、感觉和/或括约肌功能障碍经血浆置换（2周内进行4至6次）后得到改善，且效果维持2至4周。血浆置换降低了血清中HTLV-I抗体的滴度，但脑脊液中的滴度未降低，HTLV-I抗体滴度的变化与血浆置换的效果无关。这些结果表明，血浆置换对HAM患者是一种有效的治疗方法，至少能产生暂时的改善，并且在HAM的发病机制中，某些体液因子而非HTLV-I抗体可能起重要作用。
