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多发性硬化症的长期淋巴细胞去除术治疗。初步观察

Long-term lymphocytapheresis therapy in multiple sclerosis. Preliminary observations.

作者信息

Maida E, Höcker P, Mann E

出版信息

Eur Neurol. 1986;25(3):225-32. doi: 10.1159/000116012.

Abstract

Long-term lymphocytapheresis (LPH) therapy was applied in 9 patients with a relapsing-remitting course of multiple sclerosis (MS) and a high frequency of bouts. The therapeutic scheme included series of 4 LPH within 8 days, which were repeated every 6-8 weeks during 1 year or longer, until the myelin-reactive T cell test--which was used for immunological control--became normal. Altogether, the therapy was well tolerated, but severe problems with the veins occurred in 2 of the 9 patients. No bouts during LPH therapy were seen in 7 of the 9 patients. The 3 patients with the shortest duration of the disease showed an improvement of the Kurtzke scale. No relapses or a reduced relapse rate--compared to the time before LPH therapy--was observed in 6 of the 9 patients during the follow-up period of up to 23 months. Conclusively, long-term LPH therapy seems to be recommended as an alternative to the continuous administration of immunosuppressive drugs, especially for active cases of MS with a short duration of the disease.

摘要

对9例复发缓解型多发性硬化症(MS)且发作频繁的患者应用了长期淋巴细胞去除术(LPH)治疗。治疗方案包括在8天内进行4次LPH治疗系列,在1年或更长时间内每6 - 8周重复一次,直到用于免疫控制的髓鞘反应性T细胞检测结果恢复正常。总体而言,该治疗耐受性良好,但9例患者中有2例出现了严重的静脉问题。9例患者中有7例在LPH治疗期间未出现发作。病程最短的3例患者库尔特克量表评分有所改善。在长达23个月的随访期内,9例患者中有6例未观察到复发或与LPH治疗前相比复发率降低。总之,长期LPH治疗似乎可作为持续使用免疫抑制药物的替代方案,尤其适用于病程短的活动性MS病例。

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