血浆置换治疗弥漫性硬皮病的前瞻性研究

A PROSPECTIVE STUDY OF PLASMA EXCHANGE IN THE TREATMENT OF DIFFUSE SCLERO-DERMA

报告血浆置换（ＰＥ）合用青霉时治疗１３例弥漫性硬皮病患者（Ⅰ组）的疗效，并与青霉胺治疗的１６例患者（Ⅱ组）进行比较。Ⅰ组于ＰＥ结束时皮肤积分、齿距、指距、关节压痛指数、握力、血沉、ＩｇＧ、血浆肾素、血管紧张素Ⅱ与治疗前相比有显著改善（Ｐ＜０．０５～ｐ＜０．０１），医生和患者评价有效率分别为６１．１％和６９．２％。观察至治疗后１８个月，病情继续改善，疗效与Ⅱ组相比差异有显著性（Ｐ＜０．０５）。７８次ＰＥ中发生低血压４次，经处理后恢复正常。

prospective randomized study to compare the efficacy between plasma exchange(PE)plus D-peni-cillamine(13 cases)(groupⅠ)and D-penicillamine alone(16 cases)(group Ⅱ) in the treatment of diffuse scleroderma was carried out.Total skin score,the distance hetween finger and palm,the distance between upper and lower teeth,the index of joint tenderness,grip strength, ESR, IgG,plasma renin and an-giotensin Ⅱ were measured. After 6 times of PE, all parameters in group Ⅰ showed significant improvement as compared with those before treatment(P<0. 05～p< 0.01).The overall effective rates evaluated by physicians and by patients were 61.1%and 69.2% respectively,One and half year after the 6 times of PE,all paramaters in groupⅠ were lower than those in group Ⅱ(P<0. 05).In groupⅠthere were less in-ternal organ impairment and hypertension than in group Ⅱ. The commonest side effect of PE was hypoten-sion;it disappeared after transfusion.