Cotter F E, Newland A C, Turnbull A L
Vox Sang. 1983;45(3):197-204. doi: 10.1111/j.1423-0410.1983.tb01905.x.
We present data on 5 cases with autoimmune thrombocytopenic purpura treated with plasma exchange in whom conventional drug therapy had been ineffective. In 3, preparation for splenectomy allowed the operation to be performed without bleeding problems. 1 patient who was unfit for splenectomy underwent successful coronary artery vein grafting following preparation with plasma exchange. 2 patients were maintained for variable periods with intermittent exchanges, 1 prior to splenectomy and 1 post-splenectomy. In summary we had no prolonged response to plasma exchange but found it a useful technique as preparation for or adjunctive to more conventional therapy. It was also helpful in patients unresponsive to other forms of therapy who required a brief increase in platelet count to cover surgery or spontaneous haemorrhage.
我们展示了5例自身免疫性血小板减少性紫癜患者接受血浆置换治疗的数据，这些患者接受传统药物治疗无效。其中3例，脾切除术的准备工作使得手术得以顺利进行，未出现出血问题。1例不宜进行脾切除术的患者在血浆置换准备后成功进行了冠状动脉静脉搭桥术。2例患者通过间歇性置换维持了不同时间段，1例在脾切除术前，1例在脾切除术后。总之，我们未观察到血浆置换有长期疗效，但发现它作为更传统治疗的术前准备或辅助手段是一项有用的技术。对于那些对其他治疗形式无反应、需要短暂提高血小板计数以应对手术或自发性出血的患者，它也有帮助。
