急性炎症性神经系统疾病患者血浆置换抢救治疗的有效性和安全性:单中心经验

IF 3.2 Q2 CLINICAL NEUROLOGY
Salvatore Iacono, Giuseppe Schirò, Giuseppe Salemi, Elisabetta Scirè, P. Aridon, Michele Melfa, Michele Andolina, Gabriele Sorbello, Andrea Calì, Filippo Brighina, M. D’Amelio, P. Ragonese
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引用次数: 0

摘要

背景:治疗性血浆置换(TPE)是神经免疫疾病急性加重患者的一种高效抢救治疗方法,可清除血液中的循环自身抗体和炎症成分。本研究旨在探讨 TPE 对自身免疫性神经疾病患者的安全性和有效性。方法:我们采用改良等级量表(mRS)对在巴勒莫大学医院接受 TPE 治疗的急性神经系统疾病发作患者的不良事件(AEs)频率和 TPE 的有效性进行了回顾性评估。结果:在59名患者中,大多数人因多发性硬化症(MS)复发而接受了TPE治疗。在23.7%的病例中,由于临床表现严重,在获得明确诊断前进行了TPE。TPE后,mRS评分全面下降(p < 0.0001),这一效果在多发性硬化症、格林-巴利综合征和重症肌无力危象患者中明显,但在副肿瘤综合征患者中并不明显。循环中的致病抗体、年轻和早期使用 TPE 与 TPE 的有效性密切相关。TPE的总体安全性令人满意,AE发生率为15%。结论:这些结果凸显了TPE在循环致病性抗体患者中的早期应用及其良好的安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and Safety of Rescue Treatment with Plasma Exchange in Patients with Acute Inflammatory Neurological Disorders: A Single Center Experience
Background: Therapeutic plasma exchange (TPE) is a highly effective rescue treatment for patients with acute exacerbation of neuroimmunological disease that removes circulating autoantibodies and inflammatory components from the bloodstream. The aims of this study are to explore the safety and the effectiveness of TPE in patients with autoimmune neurological disorders. Methods: We retrospectively evaluated the frequency of adverse events (AEs) and the effectiveness of TPE using the modified Ranking Scale (mRS) in patients with acute neurological flares who underwent TPE at the University Hospital of Palermo. Results: Of 59 patients, the majority underwent TPE due to multiple sclerosis (MS) relapse. In 23.7% of cases, TPE was performed before obtaining a definite diagnosis due to the severity of the clinical presentation. After TPE, the mRS score was globally reduced (p < 0.0001), and this effect was marked in patients with MS, Guillain–Barré syndrome, and myasthenia gravis crisis but not in those with paraneoplastic syndromes. Circulating pathogenetic antibodies, younger age, and the early use of TPE were factors strongly associated with TPE effectiveness. The overall safety profile of TPE was satisfactory with an AE frequency of 15%. Conclusions: These results highlight the early use of TPE in patients with circulating pathogenetic antibodies as well as its favorable safety profile.
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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
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