Wensley R T, Stevens R F, Burn A M, Delamore I W
Br Med J. 1980 Nov 22;281(6252):1388-9. doi: 10.1136/bmj.281.6252.1388.
Plasma exchanges were combined with human factor VIII concentrate therapy in the treatment of major bleeding episodes in five patients with haemophilia A and factor VIII inhibitors. All patients had a good clinical response to combined treatment. Inhibitor levels showed satisfactory falls before rapid secondary increases of inhibitor levels took place. A sixth patient with von Willebrand's disease and a factor VIII clotting activity inhibitor was successfully prepared for operation using plasma exchange. Postoperative haemostasis and healing were normal. In two patients the plasma exchanges were relatively more effective than the administered human factor VIII in reducing the levels of factor VIII inhibitor. Combined plasma exchange and human factor VIII treatment may offer a rapidly effective means of reducing factor VIII inhibitor levels in this group of patients, together with significant saving of costs.
对5例患甲型血友病且有凝血因子Ⅷ抑制剂的患者，采用血浆置换与人凝血因子Ⅷ浓缩物疗法联合治疗严重出血发作。所有患者对联合治疗均有良好的临床反应。在抑制剂水平迅速继发升高之前，其水平出现了令人满意的下降。第6例患血管性血友病且有凝血因子Ⅷ凝血活性抑制剂的患者，通过血浆置换成功地为手术做了准备。术后止血及愈合均正常。在2例患者中，血浆置换在降低凝血因子Ⅷ抑制剂水平方面相对比给予的人凝血因子Ⅷ更有效。血浆置换与人凝血因子Ⅷ联合治疗可能为降低该组患者凝血因子Ⅷ抑制剂水平提供一种迅速有效的方法，同时还能显著节省费用。
