Osman Chinar, Jennings Rachel, El-Ghariani Khaled, Pinto Ashwin
Neurosciences, Wessex Neurological Centre, Southampton, UK
Neurosciences, Wessex Neurological Centre, Southampton, UK.
Pract Neurol. 2020 Apr;20(2):92-99. doi: 10.1136/practneurol-2019-002336. Epub 2019 Jul 12.
Plasma exchange is a highly efficient technique to remove circulating autoantibodies and other humoral factors rapidly from the vascular compartment. It was the first effective acute treatment for peripheral disorders such as Guillain-Barré syndrome and myasthenia gravis before intravenous immunoglobulin became available. The recent recognition of rapidly progressive severe antibody-mediated central nervous system disorders, such as neuromyelitis optica spectrum disorders and anti-N-methyl-D-aspartate-receptor encephalitis, has renewed interest in using plasma exchange for their acute treatment also. In this review we explain the principles and technical aspects of plasma exchange, review its current indications, and discuss the implications for its provision in the UK.
血浆置换是一种高效技术，可迅速从血管腔中清除循环自身抗体和其他体液因子。在静脉注射免疫球蛋白问世之前，它是治疗格林-巴利综合征和重症肌无力等周围性疾病的首个有效急性治疗方法。最近，人们认识到快速进展的严重抗体介导的中枢神经系统疾病，如视神经脊髓炎谱系疾病和抗N-甲基-D-天冬氨酸受体脑炎，这也重新激发了对使用血浆置换进行急性治疗的兴趣。在本综述中，我们解释了血浆置换的原理和技术方面，回顾了其当前的适应症，并讨论了在英国提供血浆置换的意义。
