血浆交换治疗四种免疫性疾病的机理和疗效检测的初步探讨

A preliminary study of the mechanism and therapeutic effect in four types of immunic diseases with plasmapheresis

本文介绍血浆交换(plasma exchange,PE)治疗8例四种免疫性疾病,应用PE前后测定外周血T细胞集落数、单克隆抗体(monoclone antibody,McAb)对T细胞亚群的标记和循环免疫复合物(circulating immune complex,CIC)的改变及其相互间关系的比较,探索PE产生疗效的机理和检测疗效的指标。实验资料提示,PE后机体内有害抗体、CIC的清除、细胞免疫功能的词正等均属产生疗效的机理,系综合性的作用。检测疗效的指标有T细胞集落数(TL-CFU)、CIC值和T_H与T_S比值的恢复。PE后CIC下降、T_H上升,与PE前相比其P值均<0.01。而换浆后含有病人血浆及血清成份的T细胞集落数的恢复正常,对检测PE后的疗效尤为敏感、确切。

This paper presents plasma exchange(P.E) therapy in 8 cases of four types of immunic diseaes. The colony forming unit-T lymphocyte (TL-CFU), the symbol T-cell subsets with monoclone antibody (McAb), and the cisrculating immune complex (CIC)were examined before and after the therapy of P.E. and compared with the interelationship of each other. The experiments indicated that plasmapheresis may remove the CIC and noxious autoantibodies and regulation of the action of cellular immunity. All these functions are synthetic therapeutic effects. The indices of checkup on therapeutics were: TL-CFU, CIC and the ratio of T_H and T_S. After plasmaphersis, the ratio of CIC was lowered but the TL was higer than before (P<0.01). The most sensitive and accurate is the number of T-CFU back to normal with the patient's plasma and sero-cultures.