Department of Nephrology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
Department of Pathology and Cell Biology, Columbia University Medical Center, New York, USA.
Nephrol Dial Transplant. 2017 Sep 1;32(9):1461-1463. doi: 10.1093/ndt/gfx090.
The rationale behind the use of plasma exchange (PE) includes the removal of autoantibodies and other plasma constituents, such as cytokines, complement components, neutrophil extracellular traps, and microparticles, and the substitution of missing plasma factors. The more established indications are associated with the beneficial effects of PE of reducing the plasma levels of pathogenic agents, although the efficiency of this process decreases during the course of the procedure as the substituted replacement fluid dilutes the patient's original plasma. Thus, removal can be more effective by repeating sessions rather than continuing so-called high-volume PE. The kinetics of PE efficiency have been extensively investigated and exchange between body compartments of substances to be removed is of considerable importance.
使用血浆置换（PE）的基本原理包括清除自身抗体和其他血浆成分，如细胞因子、补体成分、中性粒细胞胞外诱捕网和微颗粒，以及替代缺失的血浆因子。更确定的适应证与 PE 降低致病因子血浆水平的有益效果有关，尽管随着替代置换液稀释患者原始血浆，该过程的效率在治疗过程中会降低。因此，通过重复治疗而非继续所谓的大容量 PE 可以更有效地清除。PE 效率的动力学已得到广泛研究，待清除物质在体内各隔室之间的交换具有重要意义。
