微循环检测在自身免疫性溶血性贫血患者治疗性血浆置换中的应用

Microcircular Study in Autoimmune Hemolytic Anemia Treated by Therapeutic Plasma Exchange

目的:观察自身免疫性溶血性贫血(AIHA)患者应用治疗性血浆置换(TPE)的疗效及微循环变化。方法:71例AIHA患者随机分为常规治疗组、山莨菪碱(654-2)治疗组和TPE治疗组,观察三组病例疗效及治疗前和症状缓解时甲襞微循环和血流变参数变化,并与正常对照组一起进行统计学分析。结果:TPE治疗组完全缓解(CR)率高于、达CR时间早于常规治疗组及654-2治疗组(P<0.05)。三组病例达CR时甲襞微循环指标仅TPE组袢周状态积分及总积分值显著高于正常对照组(P<0.05),其它指标均与正常对照组无显著差异(P>0.05)。血流变指标全部恢复正常对照组水平。结论:TPE治疗能快速清除AIHA自身抗体及胆红素,提高疗效。微循环学检查有助于治疗过程的动态检测。

Objective:To study the therapeutic effect and microcircular change in auto immune hemolytic anemia(AIHA) treated by therapeutic plasma exchange(TPE). Method: 71 cases of AIHA patients were divided into conventional therapy group,654-2 group and TPE group randomly. To observe and statistical analyse the therapeutic effect and the change of nailfold microcirculation and hemorheology before curatio and after complete remission(CR). Results: The CR rate and time in TPE group is higher and shorter than conventional therapy group and 654-2 group(P<0.05),total remission rate shown no difference between conventional therapy group,654-2 group and TPE group(P>0.05). After CR,Only the vascular surrounding state integral and total integral in TPE group higher than the control group(P<0.05),the other integrals shown no difference between the 3 therapy groups and control group. And hemorheological index shown no difference with control group. Conclusion: TPE can clean the auto-antibody and bilirubin up expeditiously and increase the therapeutic effect of AIHA. The microciucular examination is beneficial to the dynamically observation during TPE.