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重症肌无力的脾区及全身照射治疗

Splenic and total-body irradiation treatment of myasthenia gravis.

作者信息

Engel W K, Lichter A S, Dalakas M C

出版信息

Ann N Y Acad Sci. 1981;377:744-54. doi: 10.1111/j.1749-6632.1981.tb33772.x.

Abstract

X-irradiation is introduced as a new therapeutic technique in the treatment of otherwise intractable myasthenia gravis (MG) and polymyositis (PM), on the basis that these dysimmune diseases are "lymphocyte dyscrasias" and that lymphocytes are the circulating cells most sensitive to x-irradiation. Splenic irradiation, 1000 rads per two-week course, repeated up to three courses, in five MG patients produced objective improvement in three and subjective improvement in another. The improvement was transient and accompanied by a temporary lymphocytopoenia. Total Body Irradiation (TBI), 150 rads over five weeks, in one polymyositis patient was followed by remarkable improvement, sustained and still increasing now after one year, associated with a sustained lymphocytopoenia. One MG patient has had definite improvement, maintained to the present, seven months after TBI, associated with persistent lymphocytopoenia. We suggest TBI may also be a treatment applicable to other types of dysimmune (autoimmune) diseases.

摘要

X线照射作为一种新的治疗技术被引入,用于治疗其他方法难以治愈的重症肌无力(MG)和多发性肌炎(PM),其依据是这些免疫失调疾病属于“淋巴细胞异常增生”,而淋巴细胞是对X线照射最敏感的循环细胞。对5例重症肌无力患者进行脾区照射,每两周疗程为1000拉德,重复至多三个疗程,其中3例有客观改善,另1例有主观改善。改善是短暂的,且伴有暂时性淋巴细胞减少。对1例多发性肌炎患者进行全身照射(TBI),五周内照射150拉德,之后有显著改善,一年后仍持续且仍在进展,伴有持续性淋巴细胞减少。1例重症肌无力患者在接受全身照射七个月后有明确改善且持续至今,伴有持续性淋巴细胞减少。我们认为全身照射也可能适用于其他类型的免疫失调(自身免疫)疾病。

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