血浆置换治疗急性期视神经炎

Therapeutic plasma exchange for acute optic neuritis

治疗性血浆置换(therapeutic plasma exchange,TPE)能有效清除血清中的抗体及促炎性细胞因子等致病物质,并对患者免疫功能具有调节作用。急性视神经炎甲泼尼龙静滴(intravenous methylprednisolone,IVMP)3~5天视力恢复不明显或不宜继续用糖皮质激素治疗者可考虑应用TPE,但应注意过敏反应和电解质紊乱等不良事件的防范。TPE对急性视神经炎的确切疗效以及最佳治疗方案等问题,尚需进一步循证研究。

Therapeutic plasma exchange （TPE） can remove the pathogenic components effectively such as autoimmune antibodies and proinflammatory cytokines in serum. It may also modify the immune function of patients. If patients with acute optic neuritis （ON） do not respond to intravenous methylprednisolone （IVMP） therapy or they are intolerant to IVMP, TPE may be beneficial in the acute setting. However, adverse events such as allergy and electrolyte disturbances should be alerted. The exact effect of TPE for acute ON and its optimal treatment strategy need to be further investigated.