Nydegger U, Aeschbacher B
Hämatologisches Zentrallabor der Universität, Inselspital, Bern.
Schweiz Med Wochenschr. 1987 Jul 25;117(30):1140-51.
After a rather long initial period fraught with difficulties, plasma exchange has become an adjunct to the treatment of numerous diseases in medicine, such as hyperviscosity syndrome, where it alleviates disease symptoms, hemophilia due to inhibitors to clotting factor VIII, thrombotic thrombocytopenic purpura, rapidly progressing and Goodpasture glomerulonephritis, myasthenia gravis and Guillain Barre syndrome. As yet there are no formal indications for plasmapheresis, i.e. randomized placebo controlled studies are rare and proof of efficacy is often based on clinical criteria only. Therefore this treatment may be a transient means of removing noxious substances from plasma, giving way to more specific apheresis procedures such as plasma filtration, cascade filtration or immunoadsorption over charcoal or over solid-phase bound antibodies against the substance it is desired to remove. The present study presents the various plasmapheresis techniques, outlines the pathophysiological background to this treatment and adopts the now standard classification of indications into hematological, nephrological, neurological and miscellaneous indications. The English speaking reader will find an updated reference list of work published mainly in that language.
在经历了一段相当漫长且充满困难的初始阶段后，血浆置换已成为医学上众多疾病治疗的辅助手段，如高黏滞综合征（可缓解疾病症状）、因凝血因子 VIII 抑制剂导致的血友病、血栓性血小板减少性紫癜、快速进展性和肺出血肾炎综合征、重症肌无力以及吉兰 - 巴雷综合征。目前尚无血浆置换的正式指征，即随机安慰剂对照研究很少，疗效证据往往仅基于临床标准。因此，这种治疗可能是从血浆中去除有害物质的一种临时手段，会被更具特异性的血液分离程序所取代，如血浆过滤、级联过滤或通过活性炭或针对欲去除物质的固相结合抗体进行免疫吸附。本研究介绍了各种血浆置换技术，概述了该治疗的病理生理背景，并采用了目前标准的适应证分类，分为血液学、肾脏病学、神经病学和其他适应证。说英语的读者会找到一份主要以该语言发表的最新参考文献列表。
