免疫吸附疗法在急性炎症性脱髓鞘性多发性神经病中的疗效研究

Curative effect of immune adsorption in treatment of acute inflammatory demyelinating polyneuropathy

目的：分析免疫吸附疗法（IA）在急性炎症性脱髓鞘性多发性神经病（AIDP）中的疗效,并与传统的血浆置换疗法（PE）进行对比。方法：分析2011年1月-2014年1月在我院接受治疗的AIDP患者的临床资料,依据患者治疗方法不同分为观察组（IA法治疗）、对照组（PE法治疗）。结果：治疗后2周,观察组患者Hughes评分显著低于对照组（2.31±0.94 vs.2.85±1.02;t=2.085,P=0.042）。治疗后观察组患者C-反应蛋白水平显著低于对照组[（7.21±2.89）mg/L vs.（11.51±3.35）mg/L;t=5.194,P〈0.001）];治疗后观察组患者肿瘤坏死因子-a（TNF-α）水平显著低于对照组[（21.25±7.15）mg/Lvs.（28.40±8.65）mg/L;t=3.400,P=0.001）]。Pearson相关性分析显示,Hughes评分与C-反应蛋白呈现显著性正相关（r=0.463,P〈0.001）;Hughes评分与TNF-α呈现显著性正相关（r=0.491,P〈0.001）。结论：免疫吸附疗法治疗AIDP疗效可靠,其清除血浆促炎因子的疗效优于血浆置换。

Objective：To analyze the curative effect of immune adsorption（IA）in the treatment of acute inflammatory demyelinating polyneuropathy（AIDP）compared with that of plasma exchange（PE）.Methods：Clinical data of patients with AIDP received treatment at our hospital from 2011 to 2014were analyzed.Patients were divided into two groups by different treatment,Group A：IA;Group B：PE.Results：Two weeks after treatment,patients in Group A had a low level of Hughes scores than that of Group B,the difference was statistically significant（2.31±0.94 vs 2.85±1.02;t=2.085,P=0.042）.Group A had lower levels of CRP（7.21±2.89 vs 11.51±3.35;t=5.194,P〈0.001）and TNF-α（21.25±7.15 vs 28.40±8.65;t=3.400,P=0.001）when compared with Group B.Correlation analysis showed that the Hughes scores had significant positive correlation with CRP（r=0.463,P〈0.001）and TNF-α（r=0.491,P〈0.001）.Conclusion：In the treatment of AIDP,IA can achieve a better curative effect than that of PE.