Aringer M, Smolen J S, Graninger W B
Vienna General Hospital, University of Vienna, Austria.
Arthritis Rheum. 1998 Mar;41(3):414-20. doi: 10.1002/1529-0131(199803)41:3<414::AID-ART6>3.0.CO;2-N.
To assess the risk of infection in patients with systemic lupus erythematosus (SLE) treated with plasmapheresis in addition to intravenous (I.V.) pulse cyclophosphamide (CYC).
We searched the records of all our SLE patients for those who had undergone plasmapheresis plus I.V. CYC treatment (n = 9). Consecutive patients with similarly high SLE activity who underwent I.V. CYC therapy but not plasmapheresis were included as controls (n = 12). We evaluated both groups for severe infections, outcome, and confounding clinical variables.
Seven of 9 plasmapheresis-treated patients had serious bacterial or viral infections, including 3 cases of cytomegalovirus infections. Among the 12 patients treated with I.V. CYC alone, only 2 had severe infections (P < 0.01). Three patients in the plasmapheresis group and none in the control group died of infections. Treatment efficacy, however, was similar for both groups.
Among SLE patients treated with plasmapheresis and I.V. CYC, life-threatening bacterial and viral infections and mortality occur more frequently than among patients with similarly active SLE treated with I.V. CYC alone.
评估系统性红斑狼疮（SLE）患者在接受静脉注射脉冲环磷酰胺（CYC）治疗的基础上进行血浆置换时的感染风险。
我们在所有SLE患者的记录中查找接受血浆置换加静脉注射CYC治疗的患者（n = 9）。将连续接受静脉注射CYC治疗但未进行血浆置换且SLE活动度同样较高的患者作为对照（n = 12）。我们评估了两组患者的严重感染情况、结局以及混杂的临床变量。
9例接受血浆置换治疗的患者中有7例发生了严重的细菌或病毒感染，其中包括3例巨细胞病毒感染。在仅接受静脉注射CYC治疗的12例患者中，只有2例发生了严重感染（P < 0.01）。血浆置换组有3例患者死于感染，而对照组无患者死于感染。然而，两组的治疗效果相似。
在接受血浆置换和静脉注射CYC治疗的SLE患者中，危及生命的细菌和病毒感染及死亡率比仅接受静脉注射CYC治疗且SLE活动度相似的患者更频繁。
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