血浆置换治疗自身免疫性疾病临床疗效分析

Analysis of clinical efficacy of plasma exchange in patients with autoimmune diseases

目的探讨血浆置换治疗自身免疫性疾病患者的临床疗效.方法将80例自身免疫性疾病患者按照随机数字表法分为研究组与对照组,各40例.研究组给予血浆置换治疗,对照组给予注射免疫球蛋白治疗,观察住院全程.比较治疗前及治疗1周、2周末两组Hughes及英国医学研究理事会评分,补体C3、C4,纤维蛋白原,免疫球蛋白G、免疫球蛋白A、免疫球蛋白M,单核细胞百分比水平,比较两组临床疗效.结果 治疗1周末起两组Hughes评分较治疗前显著持续降低(P<0.01),英国医学研究理事会评分较治疗前显著持续升高(P<0.01),治疗2周末研究组较对照组变化更显著(P<0.05).治疗1周末起两组C3、C4、单核细胞百分比、纤维蛋白原、免疫球蛋白G、免疫球蛋白A、免疫球蛋白M水平均较治疗前显著持续降低(P<0.05或0.01),治疗2周末研究组纤维蛋白原,免疫球蛋白G、免疫球蛋白A、免疫球蛋白M水平显著低于对照组(P<0.01).治疗2周末研究组总有效率显著高于对照组(P<0.05).结论血浆置换疗法治疗自身免疫性疾病效果较好,能有效促进患者神经功能恢复,改善临床症状.

Objective To study the clinical efficacy of plasma exchange in patients with autoimmune disea­ses.Methods 80 patients with autoimmune diseases were divided into research group and control group according to random number table method,40 cases each.The study group was given plasma exchange and the control group was given immunoglobulin injection to observe the whole hospitalization.Hughes and MRC scores were compared between the two groups before treatment and at 1 week and 2 weeks after treatment.Compare the levels of complement C3,C4,FIB,IgG,IgA,IgM,and MON before treatment and at 1week and 2 weeks after treatment,compare the clinical efficacy of the two groups.Results From the end of 1 week of treatment,the Hughes scores of the two groups were significantly and continuously decreased(P<0.01),and the MRC scores were significantly and continuously increased(P<0.01).Af­ter 2 weeks of treatment,the study group changed more significantly than the control group(P<0.05).From the end of1 week of treatment,the levels of C3,C4,MON,FIB,IgG,IgA,and IgM in the two groups continued to decrease significantly compared with before treatment(P<0.05 or 0.01).After 2 weeks of treatment,the FIB,IgG,IgA,and IgM levels in the study group were significantly lower than those in the control group(P<0.01).After 2 weeks of treatment,the total effective rate of the study group was significantly higher than that of the control group(P<0.05).Conclusions Plasma exchange therapy is effective in treating autoimmune diseases,and can effectively promote the recovery of patients7 neurological function and improve clinical symptoms.