Leaker B R, Becker G J, Dowling J P, Kincaid-Smith P S
Clin Nephrol. 1986 May;25(5):236-44.
We report our experience of intensive plasma exchange (PE) in the treatment of 12 females with severe diffuse proliferative lupus nephritis. All had active disease with crescentic lesions demonstrated on biopsy immediately before PE. Nine patients were also treated with high dose steroids, three patients with low dose steroids and most patients also received cytotoxic therapy. Eight of the 12 patients were biopsied immediately after a course of PE. All but one patient (low dose steroid group) showed considerable diminution of histologic activity with resolution of crescentic lesions. Plasma exchange may accelerate such resolution over conventional therapy, prevent subsequent sclerosis and preserve functional renal tissue.
我们报告了强化血浆置换（PE）治疗12例重症弥漫性增殖性狼疮性肾炎女性患者的经验。所有患者在进行血浆置换前活检均显示有新月体病变，且病情处于活动期。9例患者接受了大剂量类固醇治疗，3例患者接受小剂量类固醇治疗，大多数患者还接受了细胞毒性疗法。12例患者中有8例在一个疗程的血浆置换后立即接受了活检。除1例患者（小剂量类固醇组）外，所有患者的组织学活动度均显著降低，新月体病变消退。与传统治疗相比，血浆置换可能加速这种消退，预防随后的硬化，并保留功能性肾组织。
