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目的探讨血浆置换(plasma exchange,PE)治疗难治性类风湿关节炎的疗效和安全性。方法入选患者18名均进行PE,检测PE前后患者IgG、IgA、IgM、ESR、CRP、RF含量。观察患者置换中不良反应及临床症状改善情况。结果PE治疗后较置换前IgG、IgA、IgM、ESR、CRP、RF含量差异有统计学意义;临床症状均明显改善;1例首次治疗后出现轻微反跳现象,3例出现不良反应(不良反应率为16.7%),症状均较轻,对症处理后好转。结论PE治疗难治性类风湿关节炎的疗效肯定,起效快,尤其短期疗效显著,毒副作用小,安全性好。
Objective To investigate the efficacy and safety of plasma exchange (PE) in the treatment of refractory rheumatoid arthritis. Methods Eighteen PE patients were enrolled in this study. The levels of IgG, IgA, IgM, ESR, CRP and RF were measured before and after PE. To observe the adverse reactions in patients with replacement and clinical symptoms improved. Results The levels of IgG, IgA, IgM, ESR, CRP and RF in PE before treatment were significantly different. The clinical symptoms were significantly improved. One case had slight rebound after the first treatment and 3 cases had adverse reactions Rate of 16.7%), the symptoms are mild, symptomatic improvement after treatment. Conclusions The curative effect of refractory rheumatoid arthritis with PE is definite and has rapid onset, especially for short-term curative effect, little side effect and good safety.