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采用冷酒精分馏法,从混合血浆中制备人免疫球蛋白。这种粗制品,多价IgG主要在Ⅱ级和Ⅲ级分馏中获得。该产品用于治疗大约有15年,因为不能静脉内给药而受限制。后来,制备工序进行了改进,制备出的免疫球蛋白可以安全的用于静脉内给药,同时作为药品也增加了它的安全性。这种可以大剂量静脉内给药的方式有效的应用了20多年。于是,治疗中用免疫球蛋白的适应症大大增加,以致于世界上广泛的供应该产品。于是人们正努力开发这种资源有限的产品满足需要。无指征的广泛使用免疫球蛋白,不仅在临床时间中不可取,而且是免疫球蛋白供不应求的原因之一。作者讨论免疫球蛋白在治疗中的应用,可靠试验依据或合理使用的指征。介绍主要包括抗体缺乏的替代治疗和许多免疫失调中作为“免疫调节剂”的处理方法。作者除了对疗效有可靠依据的较少病种论述外,还介绍了在如下病种中的应用:原发和继发的抗体缺乏状态、原发性血小板减少性紫癜(ITP)、格林巴利综合症、慢性脱髓鞘多神经病、重症肌无力、皮肌炎和山崎病。一些应用是试验性,临床医生应按照基本规则用药,对这些贵重稀少的药品不要随便开处方。
Cold alcohol fractionation is used to prepare human immunoglobulins from pooled plasma. This crude product, multivalent IgG, is mainly obtained in the fractional distillation of grade II and III. The product is used for about 15 years of treatment because it can not be administered intravenously. Later, the preparation process was improved, the prepared immunoglobulin can be safely used for intravenous administration, while also increasing its safety as a medicine. This can be a large dose of intravenous administration of the effective application of more than 20 years. As a result, indications of immunoglobulins for use in therapy are greatly increased, so that the product is widely available in the world. So people are working hard to develop this resource-limited products to meet the needs. The widespread use of immunoglobulins without indications is not only undesirable in clinical practice, but also one of the reasons why immunoglobulins are in short supply. The authors discuss the use of immunoglobulins in therapy, reliable test evidence, or indications for rational use. Introduced as a treatment for “immunomodulators” that mainly include alternative therapies for antibody deficiency and many immune disorders. In addition to the less documented treatment of disease-based claims, the authors describe the use of primary and secondary antibody deficiencies, idiopathic thrombocytopenic purpura (ITP) Syndrome, Chronic demyelinating polyneuropathy, Myasthenia gravis, Dermatomyositis and Yamazaki’s disease. Some applications are experimental, clinicians should follow the basic rules of medication, these precious sparse drugs do not just prescribe.