Dyck P J, Daube J, O'Brien P, Pineda A, Low P A, Windebank A J, Swanson C
N Engl J Med. 1986 Feb 20;314(8):461-5. doi: 10.1056/NEJM198602203140801.
Plasma exchange has been reported to be efficacious in chronic inflammatory demyelinating polyradiculoneuropathy. We performed a prospective double-blind trial in which patients with static or worsening disease were randomly assigned to plasma exchange (n = 15) or to sham exchange (n = 14) for three weeks. After three weeks, we observed statistically significant differences in combined measurements of nerve conduction (total, motor, proximal, velocity, and amplitude) favoring patients who had received plasma exchange. Improvement to a greater degree than for any patient receiving sham exchange was detected in the neurologic-disability score in five patients (P = 0.025) and in subset scores for weakness and reflex in four patients (P less than 0.057). We conclude that for some patients with chronic inflammatory demyelinating polyradiculoneuropathy, plasma exchange has an ameliorating effect on neurologic dysfunction and nerve conduction, but in others no improvement is observed. Because plasma was replaced with normal serum albumin, a humoral factor or factors may have a role in the neurologic deficit of this disorder.
据报道，血浆置换疗法对慢性炎症性脱髓鞘性多发性神经根神经病有效。我们进行了一项前瞻性双盲试验，将病情稳定或恶化的患者随机分为两组，一组接受血浆置换（n = 15），另一组接受假置换（n = 14），为期三周。三周后，我们观察到在神经传导综合测量指标（总和、运动、近端、速度和波幅）方面存在统计学上的显著差异，接受血浆置换的患者表现更优。在五名患者的神经功能障碍评分中，发现改善程度超过任何接受假置换的患者（P = 0.025），在四名患者的肌无力和反射亚组评分中也有改善（P小于0.057）。我们得出结论，对于一些慢性炎症性脱髓鞘性多发性神经根神经病患者，血浆置换对神经功能障碍和神经传导有改善作用，但对另一些患者则未观察到改善。由于用正常血清白蛋白替代了血浆，一种或多种体液因子可能在该疾病的神经功能缺损中起作用。
