免疫性溶血性贫血和免疫性血小板减少性紫癜的治疗性血浆置换

Therapeutic plasma exchange in the immune hemolytic anemias and immunologic thrombocytopenic purpura.

作者信息

Brooks B D, Steane E A, Sheehan R G, Frenkel E P

出版信息

Prog Clin Biol Res. 1982;106:317-29.

Abstract

Thus, plasma exchange appears to have a potential but limited role in the care of antibody mediated injury of red cells or platelets. Its clearest indication appears to be in those uncommon instances of warm antibody mediated hemolysis with a highly fulminant course where the classical therapeutic measures do not have adequate time for effect. Similarly, such therapy appears to have significant potential in cases of acute immunologic thrombocytopenic purpura where some clinical contraindication to steroids, immunosuppressive agents or splenectomy exists. Acute ITP of pregnancy may provide another important setting for such a therapeutic approach. Finally, plasma exchange has been shown to provide temporary clinical stability in cases of chronic cold agglutinin disease.

摘要

因此，血浆置换在红细胞或血小板抗体介导损伤的治疗中似乎具有潜在但有限的作用。其最明确的适应证似乎是那些罕见的、病情高度暴发性的温抗体介导的溶血病例，此时经典治疗措施没有足够时间发挥作用。同样，在存在使用类固醇、免疫抑制剂或脾切除的临床禁忌证的急性免疫性血小板减少性紫癜病例中，这种治疗似乎具有显著潜力。妊娠急性免疫性血小板减少性紫癜可能为此种治疗方法提供另一个重要的应用场景。最后，血浆置换已被证明在慢性冷凝集素病病例中可提供暂时的临床稳定性。