Nishimura Keisuke, Waki Daisuke, Kadoba Keiichiro, Mukoyama Hiroki, Yokota Toshihiko, Murabe Hiroyuki
Department of Endocrinology and Rheumatology, Kurashiki Central Hospital, Kurashiki, Japan.
Ther Apher Dial. 2019 Jun;23(3):248-252. doi: 10.1111/1744-9987.12828. Epub 2019 May 30.
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.
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。
