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目的 :观察双重血浆置换(DFPP)治疗系统性硬化症的临床疗效及安全性。方法 :回顾性分析行DFPP的12例系统性硬化症患者的临床资料,观察DFPP前后生化、免疫指标及改良Rodnan皮肤评分的变化。结果:除1例在首次DFPP后出现体位性低血压外,无其他不良反应。DFPP后,患者免疫球蛋白Ig G、Ig M、血沉、球蛋白较置换前有明显下降,血浆置换后抗SCL-70抗体及抗着丝点抗体(ACA)、抗U1核糖核蛋白抗体(抗U1RNP抗体)无明显变化,但改良Rodnan皮肤评分明显好转(17.2±7.7 vs 23.6±9.3,P=0.007)。结论:DFPP能够改善免疫反应,改善皮肤症状,是治疗系统性硬化症的一个安全有效的方法 。
Objective: To observe the clinical efficacy and safety of double plasmapheresis (DFPP) in the treatment of systemic sclerosis. Methods: The clinical data of 12 patients with systemic sclerosis who underwent DFPP were retrospectively analyzed. The changes of biochemical and immune indexes before and after DFPP and the modified Rodnan skin score were observed. Results: There was no other adverse reactions besides 1 case of orthostatic hypotension after the first DFPP. After DFPP, the immunoglobulin Ig G, Ig M, erythrocyte sedimentation rate and globulin of patients were significantly lower than those before the replacement. After anti-SCL-70 antibody and anti-centromere antibody (ACA), anti-U1 ribonucleoprotein antibody U1RNP antibody) did not change significantly, but the modified Rodnan skin score was significantly improved (17.2 ± 7.7 vs 23.6 ± 9.3, P = 0.007). Conclusion: DFPP can improve immune response and improve skin symptoms and is a safe and effective method for the treatment of systemic sclerosis.