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血浆置换在抗中性粒细胞胞浆抗体相关性血管炎中的疗效

Efficacy of Plasma Exchange in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis.

作者信息

Nishimura Keisuke, Waki Daisuke, Kadoba Keiichiro, Mukoyama Hiroki, Yokota Toshihiko, Murabe Hiroyuki

机构信息

Department of Endocrinology and Rheumatology, Kurashiki Central Hospital, Kurashiki, Japan.

出版信息

Ther Apher Dial. 2019 Jun;23(3):248-252. doi: 10.1111/1744-9987.12828. Epub 2019 May 30.

Abstract

We aimed to investigate the efficacy of plasma exchange on severe anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Of 182 patients with AAV in our hospital, 12 patients with life-threatening organ damage (rapidly progressive glomerulonephritis and/or diffuse alveolar hemorrhage) underwent centrifuge-based therapeutic plasma exchange and immunosuppressive therapy. Twenty-four patients matched for age, serum creatinine, and severity of vasculitis, who received high-dose glucocorticoids with or without immunosuppressants, were included in the nonplasma exchange group. Renal survival rate at 2 years from induction treatment was not significantly different between the plasma and nonplasma exchange groups (P = 0.524). Mortality rate at 5 years from induction treatment was not significantly different between the plasma and nonplasma exchange groups (P = 0.631). In this retrospective study, we could not show the significant differences in the renal survival rate and survival rate between the two groups.

摘要

我们旨在研究血浆置换对重症抗中性粒细胞胞浆抗体相关性血管炎(AAV)的疗效。我院182例AAV患者中,12例出现危及生命的器官损害(快速进展性肾小球肾炎和/或弥漫性肺泡出血)的患者接受了基于离心的治疗性血浆置换和免疫抑制治疗。将24例年龄、血清肌酐和血管炎严重程度相匹配的患者纳入非血浆置换组,这些患者接受了大剂量糖皮质激素治疗,部分患者联合免疫抑制剂治疗。诱导治疗后2年时,血浆置换组和非血浆置换组的肾脏存活率无显著差异(P = 0.524)。诱导治疗后5年时,血浆置换组和非血浆置换组的死亡率无显著差异(P = 0.631)。在这项回顾性研究中,我们未能显示出两组之间肾脏存活率和生存率的显著差异。

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