Savchenko V G, Margulis E Ia, Vasiliev S A, Gorodetskiĭ V M, Ryzhko V V
Ter Arkh. 1985;57(7):102-7.
A study was made of the effect of selective plasmapheresis (SPP) on the concentration of circulating immune complexes (CIC). The method is based on precipitation at 4 degrees C of plasma fibronectin and associated macromolecular complexes by means of heparin. Sterile plasma of the patient is separated from the precipitate, frozen and kept at -20 degrees C till the next plasmapheresis during which it is returned to the patient instead of the donor's one. All 15 patients examined were exposed to 6 SPP with an interval made every 2 to 5 days. Six patients were diagnosed to have rheumatoid arthritis, 2 systemic lupus erythematosus, 3 hemorrhagic microthrombovasculitis, and 4 multiple sclerosis. The concentration of CIC was measured by precipitation with 3.5% polyethylene glycol before and after SPP, in some cases between sessions. All the patients with rheumatoid arthritis and systemic lupus erythematosus and 2 out of the 3 patients with hemorrhagic vasculitis showed an elevated content of CIC (greater than 0.150 Units OD). The CIC content appeared normal in all the patients with multiple sclerosis. After SPP 4 patients manifested a reduction in the CIC concentration, whereas in 6 it returned to normal. Such a time course correlated with the improvement of other clinical and laboratory findings. It was established that after the first session of SPP the CIC content sharply declined followed by a gradual increment and exceeded the initial values toward the beginning of the second session. After the second SPP the patients manifested the same tendencies. The CIC content reached a maximum by the third SPP and then fell from session to session.(ABSTRACT TRUNCATED AT 250 WORDS)
一项关于选择性血浆置换(SPP)对循环免疫复合物(CIC)浓度影响的研究。该方法基于通过肝素在4℃下沉淀血浆纤维连接蛋白及相关大分子复合物。将患者的无菌血浆与沉淀物分离,冷冻并保存在-20℃直至下次血浆置换,届时将其回输给患者而非供体血浆。所有15名接受检查的患者均接受了6次SPP,间隔为每2至5天一次。6名患者被诊断为类风湿性关节炎,2名患有系统性红斑狼疮,3名患有出血性微血管炎,4名患有多发性硬化症。在SPP前后,以及在某些情况下在疗程之间,通过用3.5%聚乙二醇沉淀来测量CIC的浓度。所有类风湿性关节炎和系统性红斑狼疮患者以及3名出血性血管炎患者中的2名显示CIC含量升高(大于0.150光密度单位)。所有多发性硬化症患者的CIC含量均正常。SPP后,4名患者的CIC浓度降低,而6名患者的CIC浓度恢复正常。这种时间进程与其他临床和实验室检查结果的改善相关。已确定在第一次SPP疗程后,CIC含量急剧下降,随后逐渐增加,并在第二次疗程开始时超过初始值。第二次SPP后,患者表现出相同的趋势。CIC含量在第三次SPP时达到最高,然后逐次下降。(摘要截短至250字)