色氨酸免疫吸附在神经系统自身免疫性疾病中的应用

The effect of tryptophan immunoadsorption therapy on neurological autoimmune diseases

目的观察色氨酸免疫吸附在治疗神经系统自身免疫性疾病中的作用和不良反应。方法选择2007年4月至2010年2月该院住院的神经系统自身免疫性疾病患者14例,在药物治疗的基础上进行免疫吸附治疗,观察治疗效果。结果所有患者经免疫吸附治疗后临床症状均有改善,肌力提高1~2级,5例患者恢复正常肌力。IgG、IgA、IgM均较治疗前明显降低（P〈0.05）,54例次免疫吸附治疗中共发生低血压3例次,口周麻木1例次,经对症处理后均缓解。结论色氨酸免疫吸附治疗神经系统自身免疫性疾病安全、有效,治疗后免疫球蛋白水平显著下降。

Objective To observe effects and complications of tryptophan immunoadsorption（IA） therapy on neurological autoimmune diseases.Methods From April 2007 to February 2010,14 patients（10 male,4 female） with neurological autoimmune diseases were given immunoadsorbent therapy using the tryptophan column（IMMUSORBA TR-350,ASAHI KASEI MEDICAL CO,LTD） in addition to drug therapy.Results Clinical symptom of all patients improved after IA therapy.Muscular performance was increased 1 to 2 grades.5 patients regained full muscle power.Serum immunoglobulins of IgG,IgA and IgM decreased significantly after adsorption（P0.05）.Of the 54 procedures in IA patients,4 procedures occurred adverse effects,induching 3 times of hypotension and 1 time of mouth anesthesia.All adverse effects were well controlled by symptomatic therapy.Conclusion Tryptophan IA was a safe and effective therapy on neurological autoimmune diseases.Serum immunoglobulins decrease significantly after adsorption.