双重血浆置换治疗重症肌无力的效果观察

Effect observation of double filtration plasmapheresis in treatment of myasthenia gravis

目的探讨双重血浆置换(DFPP)对重症肌无力(MG)的治疗效果。方法选择18例MG患者,其中男性8例,女性10例;年龄21~68岁,平均年龄38.2岁。进行DFPP治疗76次,平均4.2次,观察治疗前后许氏绝对与相对评分法(ARS-MG)和MG日常生活量表(MG-ADL)评分,同时对患者治疗前后空腹血标本乙酰胆碱受体抗体(AchRAb)水平进行监测。结果痊愈6例,显效9例,好转2例,无效1例,总有效率83.3%。DFPP治疗前后ARS-MG绝对评分[(18.72±5.13)分vs(9.56±4.08)分]、MG-ADL评分[(9.61±1.65)分vs(4.61±1.38)分]和AchRAb水平[(297.55±89.10)pmol/L vs(177.38±59.72)pmol/L]差异有显著统计学意义(P<0.01)。结论 DFPP能有效缓解患者的临床症状,降低患者体内AchRAb水平,是一种有效的治疗方法 。

Objective To observe the effect of double filtration plasmapheresis（DFPP） in treatment of myasthenia gravis（MG）.Method A total of 18 cases with MG were enrolled, which included 8 males and 10 females, aged 21-68 years old with mean age of 38.2 years old. All of them were performed by DFPP 76 times with mean of 4.2 times, the absolute and relative score of MG（ARS-MG） and myasthenia gravis activities of daily living（MG-ADL） before and after treatment were observed,and the changes of acetylcholine receptor antibody（AchRAb） level in fasting blood samples were monitored. Results Six cases were cured, 9 were markedly effective, 2 were improved and 1 case was ineffective. The total effective rate was 83.3 %. ARSMG absolute and relative scores before and after DFPP were [（18.72 ± 5.13） vs（9.56 ± 4.08）], MG-ADL were [（9.61 ± 1.65） vs（4.61 ± 1.38）], and AchRAb level were [（297.55 ± 89.10） pmol/L vs（177.38 ± 59.72） pmol/L], which were significant differences（P 〈0.01）. Conclusion It is demonstrated that DFPP is effective in relieving the clinical symptoms and reducing AchRAb level in patients, so it is an effective treatment method.