Newsom-Davis J, Wilson S G, Vincent A, Ward C D
Lancet. 1979 Mar 3;1(8114):464-8. doi: 10.1016/s0140-6736(79)90823-7.
Plasma exchange produces a short-term clinical improvement in myasthenia gravis (M.G.) which may be attributable to removal of acetylcholine receptor (AChR) antibody. The possibility that repeated plasma exchanges might confer cumulative long-term benefits was investigated. Serum-AChR-antibody and clinical response were followed for 4--12 months (mean 8 months) in six M.G. patients receiving 4--25 plasma exchanges of 2--4 1 together with immunosuppressive drugs (azathioprine [2.5 mg/kg] with or without alternate-day prednisone therapy), and in seven M.G. patients on immunosuppressive drugs alone. Percentage decrease in AChR antibody was not significantly different in the two treatment groups. Decline in antibody titre was associated with clinical improvement. Eight patients with previous thymoma showed significantly greater decline in antibody than the remaining five patients, irrespective of plasma exchange. Since repeated plasma exchange had no cumulative long-term benefit, the value of this treatment as used here lies only in short-term control of severe M.G. symptoms.
血浆置换可使重症肌无力（MG）患者短期内临床症状改善，这可能归因于乙酰胆碱受体（AChR）抗体的清除。本研究探讨了重复进行血浆置换是否可能带来累积的长期益处。对6例接受4至25次、每次2至4升血浆置换并联合免疫抑制药物（硫唑嘌呤[2.5mg/kg]，联合或不联合隔日泼尼松治疗）的MG患者，以及7例仅接受免疫抑制药物治疗的MG患者，随访观察血清AChR抗体及临床反应4至12个月（平均8个月）。两个治疗组AChR抗体的降低百分比无显著差异。抗体滴度下降与临床症状改善相关。8例既往有胸腺瘤的患者，无论是否进行血浆置换，其抗体下降幅度均显著大于其余5例患者。由于重复血浆置换并无累积的长期益处，此处所用该治疗方法的价值仅在于短期控制重症MG症状。
