Shibuya N, Sato T, Osame M, Takegami T, Doi S, Kawanami S
Department of Neurology, Kawatana National Hospital, Nagasaki, Japan.
J Neurol Neurosurg Psychiatry. 1994 May;57(5):578-81. doi: 10.1136/jnnp.57.5.578.
The results of a multicentre trial were analysed to evaluate the efficacy of immunoadsorption therapy for severe generalised myasthenia gravis. Twenty patients with myasthenia gravis who were concurrently receiving high dose prednisolone and azathioprine therapy were treated with an affinity-type adsorbent, using tryptophan-linked polyvinyl alcohol gel (IM-TR), according to a standardised treatment protocol. The 20 patients received five adsorption treatments within a period of 10 days. In 11, pronounced improvement of myasthenic weakness was seen and long-term remission was maintained. The treatment was especially effective in patients with thymic hyperplasia. Circulating acetylcholine receptor (AChR) antibodies were reduced by about 60% by treating one plasma volume. There was no difference in the rate of removal of the AChR antibodies between patients with thymic hyperplasia and patients with thymoma. No serious complications occurred during 100 procedures. It was concluded that the immunoadsorption therapy with IM-TR is useful in controlling symptoms in patients with severe myasthenia gravis who are otherwise unresponsive.
对一项多中心试验的结果进行了分析，以评估免疫吸附疗法对严重全身性重症肌无力的疗效。20例正在接受大剂量泼尼松龙和硫唑嘌呤治疗的重症肌无力患者，根据标准化治疗方案，使用色氨酸连接的聚乙烯醇凝胶（IM-TR）亲和型吸附剂进行治疗。这20例患者在10天内接受了5次吸附治疗。其中11例患者肌无力症状明显改善，并维持了长期缓解。该治疗对胸腺增生患者特别有效。通过处理一个血浆容量，循环乙酰胆碱受体（AChR）抗体减少了约60%。胸腺增生患者和胸腺瘤患者之间AChR抗体的清除率没有差异。在100次治疗过程中未发生严重并发症。得出的结论是，IM-TR免疫吸附疗法有助于控制严重重症肌无力患者的症状，否则这些患者无反应。
