双重血浆置换与常规疗法治疗急性吉兰-巴雷综合征的随机对照研究

Comparative Clinical Effects of Double Filtration Plasmapheresis and Routine Treatment on Guillain-Barre Syndrome by a Randomized Study

目的比较双重血浆置换(double filtration plasmapheresis,DFPP)与常规疗法治疗急性吉兰-巴雷综合征(Guillain-Barre syndrome,GBS)的临床疗效。方法将60例急性GBS患者随机分为DFPP组及常规治疗组,观察治疗前后神经功能改善状况,并检测治疗前后血液中免疫系列、补体系列及总蛋白水平。结果两组MRC(medical research council)评分于治疗1个月后、Hughes评分于治疗半年后比较差异有统计学意义,治疗后DF-PP组血液中免疫球蛋白IgG、IgA及补体C3明显低于常规治疗组,总蛋白无明显变化。结论DFPP是治疗急性GBS较为有效的方法,可明显改善患者神经功能缺损状况,其机制可能与降低血液中免疫球蛋白及补体有关。

Objective To compare the curative effects of double filtration Plasmapheresis （DFPP） and routine treatment on Guillain-Barre syndrome （GBS）. Methods Sixty patients with acute GBS were divided randomly into two groups. One group was treated with double filtration plasmapheresis, the other group was treated with routine treatment. The improvement of neurological function was observed. The immunoglobulin,complement, and total protein in blood were measured before and after therapy. Results There were significant differences in medical research council （MRC）-sum score after 1 month between the double filtration plasmapheresis group and the routine treatment group. After half a year, there were also significant differences in Huges-sumscore between the two groups. After DFPP therapy, both immunoglobulin IgG, IgA and complement C3 in blood decreased dramatically,compared with the routine treatment group. But no distinct difference was found in total protein before and after therapy. Conclusions Double filtration plasmapheresis is an effective method in the treatment of acute GBS. The mechanism is possibly associated with the decrease of immunoglobulin and complement in blood.