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真实世界中血浆置换在神经疾病中的应用:来自日本血浆置换结局和实践模式研究的结果。

Real-world application of plasmapheresis for neurological disease: Results from the Japan-Plasmapheresis Outcome and Practice Patterns Study.

机构信息

Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.

Department of Immunology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan.

出版信息

Ther Apher Dial. 2023 Feb;27(1):123-135. doi: 10.1111/1744-9987.13906. Epub 2022 Jul 17.

Abstract

INTRODUCTION

Plasmapheresis is a well-recognized treatment for autoimmune neurological diseases in Japan. However, the practice varies depending on the facility, and the actual treatment conditions are unclear.

METHODS

To clarify real-world conditions, a prospective observational study was conducted on patients with neurological diseases who were scheduled to receive plasmapheresis. A dataset was analyzed that included 887 treatments from 210 patients with myasthenia gravis (MG), multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and other diseases for 82, 30, 24, and 74 patients, respectively.

RESULTS

The types of plasmapheresis performed included immunoadsorption plasmapheresis, plasma exchange, and double filtration plasmapheresis with 620, 213, and 54 treatments, respectively. Approximately, 60% of the treatments were performed using peripheral blood access alone. Non-serious adverse events were observed in 10 patients.

CONCLUSIONS

A statistically significant improvement was observed after plasmapheresis in patients with MG, MS, and NMOSD. These were evaluated using the modified Rankin Scale.

摘要

简介

在日本,血浆置换是治疗自身免疫性神经疾病的一种公认方法。然而,由于各医疗机构的实践存在差异,实际的治疗情况尚不清楚。

方法

为了阐明真实情况,我们对计划接受血浆置换的神经疾病患者进行了一项前瞻性观察性研究。我们分析了一个数据集,其中包括 210 名患者的 887 次治疗,分别有 82 名、30 名、24 名和 74 名患者患有重症肌无力(MG)、多发性硬化症(MS)、视神经脊髓炎谱系疾病(NMOSD)和其他疾病。

结果

所进行的血浆置换类型包括免疫吸附血浆置换、血浆交换和双重滤过血浆置换,分别有 620 次、213 次和 54 次治疗。大约 60%的治疗仅使用外周血通路进行。10 名患者出现非严重不良事件。

结论

在 MG、MS 和 NMOSD 患者中,血浆置换后观察到统计学上显著的改善。这些改善通过改良 Rankin 量表进行评估。

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