Abe Yoshiyuki, Yamaji Ken, Endo Yukari, Kusaoi Makio, Nakano Soichiro, Yang Kwang-Seok, Tada Kurisu, Tsuda Hiroshi, Tamura Naoto
Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan.
Department of Internal Medicine and Rheumatology, Juntendo Koto Geriatric Medical Center, Tokyo, Japan.
Ther Apher Dial. 2020 Apr;24(2):208-214. doi: 10.1111/1744-9987.12939. Epub 2019 Aug 5.
Diffuse alveolar hemorrhage (DAH) is well known as a serious complication of microscopic polyangiitis (MPA). We examined the effectiveness of plasma exchange (PLEX) therapy to reduce mortality in Japanese DAH patients with MPA. This retrospective, double-center, observational cohort study included 20 DAH patients with MPA who were admitted to Juntendo University Hospital or Juntendo Koto Geriatric Medical Center between April 1998 and March 2018. The primary outcome was non-disease-specific mortality. The 1-year survival rate of patients with PLEX therapy (N = 4) was higher than that of patients with conventional therapy (N = 16, 75% and 13%, respectively, P = 0.037). Higher values of the 1996 Five-Factor Score (FFS) and 2009 FFS were associated with increased mortality, with hazard ratios of 2.29 (P = 0.040) and 2.41 (P = 0.043), respectively, by Cox univariate analysis. We investigated PLEX therapy for reducing mortality in DAH patients with MPA, and the 1996 FFS and 2009 FFS were both independent prognostic factors.
弥漫性肺泡出血（DAH）是显微镜下多血管炎（MPA）的一种严重并发症，广为人知。我们研究了血浆置换（PLEX）疗法对降低日本MPA合并DAH患者死亡率的有效性。这项回顾性、双中心、观察性队列研究纳入了1998年4月至2018年3月期间入住顺天堂大学医院或顺天堂小田老年医疗中心的20例MPA合并DAH患者。主要结局为非疾病特异性死亡率。接受PLEX治疗的患者（N = 4）的1年生存率高于接受传统治疗的患者（N = 16，分别为75%和13%，P = 0.037）。1996年五因素评分（FFS）和2009年FFS的较高值与死亡率增加相关，通过Cox单因素分析，风险比分别为2.29（P = 0.040）和2.41（P = 0.043）。我们研究了PLEX疗法对降低MPA合并DAH患者死亡率的作用，1996年FFS和2009年FFS均为独立的预后因素。
