血浆置换联合大剂量甲基强的松龙对自身免疫溶血性贫血发作溶血危象的急诊治疗

Clinical Observation of Plasma Exchange Emergent Therapy Companying With High-dosage Methylprednisolone for Patients with Hemolytic Crisis of Autoimmune Hemolytic Anemia（HC-AIHA）

目的探讨血浆置换联合大剂量强的松龙急诊治疗自身免疫性溶血性贫血（AIHA）发作溶血危象的临床疗效。方法采用德国费森尤斯血细胞分离机程序性血浆单采患者血浆，回输正常人新鲜灭活冰冻血浆和血浆代用品，联合大剂量甲基强的松龙治疗8例患者，男5例，女3例，每次置换血浆量2500~3000ml，连续置换2～3次。结果8例患者血浆置换联合大剂量甲基强的松龙治疗后短时间内血红蛋白逐渐上升．溶血危象纠正，置换过程有轻微不良反应，都能耐受，顺利完成。结论血浆置换联合甲基强的松龙对AIHA患者急诊治疗疗效较好。

Objective To investigate the clinical effect of plasma exchange emergency therapy companying with high-dosage methylprednisolone for patients with hemolytic crisis of autoimmune hemolytic anemia （HC-AIHA）. Methods Patients and methods Soon after there were hemolytic crisis in eight patients （male 5, female 3） diagnosed as AIHA they were treated by plasma exchange with f^esb virus-inactivated frozen plasma to replace patients plasma using plasma component apheresis separator Fresenius made in Germany companyirtg with high-dosage methylprednisolone. About 2500-3000ml plasma volume of each times per patient had been replaced for 2-3 times continuously. Results Every patients with plasma replacement companying with high-dosage methylprednisolone showed marked effect at short time. All patients were performed successfully and tiny reactions were observed. Their hemoglobin rised and hemolytic crisis alleviated after they had been treated with united therapies. Conclusion The therapy of plasma exchange emergency therapy companying with high-dosage methylprednisolone is very effective for patients with HC-AIHA.