374 例狼疮患者亚组分析显示，血浆置换的住院死亡率低于血浆分离。

Lower In-Hospital Mortality with Plasma Exchange than Plasmapheresis in a Subgroup Analysis of 374 Lupus Patients.

机构信息

Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Biomed Res Int. 2018 May 2;2018:9707932. doi: 10.1155/2018/9707932. eCollection 2018.

DOI:10.1155/2018/9707932

PMID:29854814

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5954964/

Abstract

BACKGROUND

Apheresis treatment includes plasmapheresis (PP) and plasma exchange (PE), and these terms are commonly used interchangeably. Nevertheless, the two procedures are carried out differently. The aims of this study were to investigate the mortality rate of patients who underwent therapeutic apheresis and compare the mortality rate between PP and PE.

METHODS

We conducted a medical chart review retrospective study. All identified subjects ( = 436) were over 20 years old with at least one ICD-9-CM intervention code plasmapheresis or plasma exchange and at least one diagnosis code with rheumatic disease. All of them were hospitalized to Chang Gung Memorial Hospital between 1st of January, 2000, and 31st of December, 2014.

RESULTS

436 nonoverlapping patients had never received PE and/or PP before 1 Jan, 2000. Among all the patients, 350 received PE, 63 received PP, and 23 received both therapies. Female patients accounted for 85.09% of patients. The overall mortality rate was 4.65% in the PE subgroup, 4.76% with combination therapy, and 13.46% in the PP subgroup. There were 374 patients diagnosed as SLE, which is the majority of overall patients who received PE and/or PE. In multivariate analysis, PE was the sole independent factor predictor of survival in SLE subgroup patients ( = 0.02, exp() = 0.314, 95% CI 0.12-0.81).

CONCLUSIONS

We showed that both PP and PE were used in treating a variety of autoimmune disorders. Plasmapheresis was preferentially carried out in patients with peripheral neuropathy. In 374 lupus patients treated with either PE or PP, PE is superior to PP in reducing in-hospital mortality.

摘要

背景

血浆分离术包括血浆置换术（PE）和血浆吸附术（PP），这两个术语经常互换使用。然而，这两种方法的操作过程不同。本研究的目的是调查接受治疗性血浆分离术的患者的死亡率，并比较 PP 和 PE 的死亡率。

方法

我们进行了一项回顾性病历研究。所有确定的患者（n=436）年龄均大于 20 岁，至少有一个 ICD-9-CM 干预代码血浆置换术或血浆吸附术，且至少有一个风湿性疾病的诊断代码。所有患者均于 2000 年 1 月 1 日至 2014 年 12 月 31 日在长庚纪念医院住院治疗。

结果

在 2000 年 1 月 1 日之前，从未接受过 PE 和/或 PP 的 436 例非重叠患者。在所有患者中，350 例接受了 PE，63 例接受了 PP，23 例同时接受了两种治疗方法。女性患者占患者总数的 85.09%。PE 亚组的总死亡率为 4.65%，联合治疗亚组为 4.76%，PP 亚组为 13.46%。有 374 例患者被诊断为系统性红斑狼疮，这是接受 PE 和/或 PP 的大多数患者。在多变量分析中，PE 是 SLE 亚组患者生存的唯一独立因素预测因子（ = 0.02，exp()=0.314，95%CI0.12-0.81）。