Cohen L B, Ambinder E P, Wolke A M, Field S P, Schaffner F
Gut. 1985 Mar;26(3):291-4. doi: 10.1136/gut.26.3.291.
Five patients with primary biliary cirrhosis and prolonged cholestasis underwent intensive plasmapheresis. The indications for plasmapheresis included intractable pruritus or hypercholesterolemia and xanthomatous neuropathy. Patients noted a rapid improvement of pruritus and fatigue which was sustained as long as plasmapheresis was continued. Cholesterol levels were lowered an average of 10.3 mmol/l and xanthomata were reduced in three of four patients. Two patients with painful neuropathy caused by xanthomata experienced relief of this symptom. The liver and spleen size were not affected by plasmapheresis, and activities of aminotransferases, alkaline phosphatase and titres of mitochondrial antibody remained unchanged. We conclude that plasmapheresis has a role in the therapeutic management of patients with advanced primary biliary cirrhosis who are disabled by the complications of pruritus, xanthomatous neuropathy, or hypercholesterolemia with xanthoma formation.
五例原发性胆汁性肝硬化伴长期胆汁淤积的患者接受了强化血浆置换治疗。血浆置换的指征包括难治性瘙痒、高胆固醇血症和黄瘤性神经病变。患者们注意到，只要持续进行血浆置换，瘙痒和疲劳症状就会迅速改善并持续缓解。胆固醇水平平均降低了10.3 mmol/l，四例患者中有三例的黄瘤有所减少。两名由黄瘤引起疼痛性神经病变的患者症状得到缓解。血浆置换未影响肝脏和脾脏大小，转氨酶、碱性磷酸酶活性及线粒体抗体滴度均保持不变。我们得出结论，对于因瘙痒、黄瘤性神经病变或伴有黄瘤形成的高胆固醇血症等并发症而致残的晚期原发性胆汁性肝硬化患者，血浆置换在治疗管理中具有一定作用。
