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首页> 外文期刊>Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy >Comparing the autoantibody levels and clinical efficacy of double filtration plasmapheresis, immunoadsorption, and intravenous immunoglobulin for the treatment of late-onset myasthenia gravis.
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Comparing the autoantibody levels and clinical efficacy of double filtration plasmapheresis, immunoadsorption, and intravenous immunoglobulin for the treatment of late-onset myasthenia gravis.

机译：比较双重过滤血浆置换，免疫吸附和静脉内免疫球蛋白的自身抗体水平和临床疗效，以治疗重症肌无力。

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The aim of this study was to investigate the effects of double-filtration plasmapheresis (DFPP), immunoadsorption (IA) and intravenous immunoglobulin (IVIg) in the treatment of late-onset myasthenia gravis (MG). A total of 40 late-onset MG patients were randomly divided into three groups: 15 patients were treated with DFPP; 10 patients were treated with IA; and 15 patients received IVIg. The titers of titin antibodies (Titin-ab), acetylcholine receptor antibodies (AChR-ab), presynaptic membrane antibody (Prsm-ab) were detected before and after the treatment, and the quantitative MG score (QMG score) was assessed by blinded examiners before and immediately after the entire course of treatment. The clinical efficacy, duration of respiratory support, hospital stay, and the correlation between the three antibodies and the QMG score were also analyzed. Compared to pre-treatment, the values of Titin-ab, AChR-ab, and PrsmR-ab were all dramatically decreased (P < 0.05); meanwhile the value of Titin-ab in the DFPP and IA groups decreased much more than in the IVIg group (P < 0.01); however, no statistical difference was found between the DFPP and IA groups (P > 0.05). Although the QMG score significantly improved in all three groups, it decreased much more in both the DFPP and IA groups than that in the IVIg group (P < 0.01). Symptoms were also effectively ameliorated by all treatments, but the clinical efficacy of the DFPP and IA groups was higher than the IVIg group (P < 0.05), as was the remission time (P < 0.01), the duration of hospital stay (P < 0.05), and the number of respiratory supports required (P < 0.05). Using Pearson's correlation, the decrease of Titin-ab showed a longitudinal correlation with the decrease of QMG score (r = 0.6107, P < 0.01). Both DFPP and IA showed better short-term clinical effectiveness than immunoglobulin transfusion, rapidly and effectively clearing the pathogenic antibodies in late-onset MG patients, especially for Titin-ab.
机译：这项研究的目的是研究双过滤血浆置换术（DFPP），免疫吸附（IA）和静脉注射免疫球蛋白（IVIg）在重症肌无力（MG）治疗中的作用。将40例晚期MG患者随机分为三组：15例接受DFPP治疗; 15例接受DFPP治疗。 IA治疗10例; 15例患者接受了IVIg。在治疗前后检测滴定蛋白抗体（Titin-ab），乙酰胆碱受体抗体（AChR-ab），突触前膜抗体（Prsm-ab）的滴度，并由盲法检查者评估定量MG评分（QMG评分）在整个疗程之前和之后。还分析了临床疗效，呼吸支持时间，住院时间以及这三种抗体与QMG评分之间的相关性。与预处理相比，Titin-ab，AChR-ab和PrsmR-ab的值均显着降低（P <0.05）。同时，DFPP组和IA组的Titin-ab值下降幅度均大于IVIg组（P <0.01）。然而，DFPP组和IA组之间没有统计学差异（P> 0.05）。尽管QMG评分在所有三个组中均显着改善，但DFPP和IA组的QMG评分均比IVIg组的降低幅度更大（P <0.01）。所有疗法均能有效缓解症状，但DFPP和IA组的临床疗效均高于IVIg组（P <0.05），缓解时间（P <0.01），住院时间（P <0.01）。 0.05），以及所需的呼吸支持次数（P <0.05）。使用皮尔逊相关性，Titin-ab的减少与QMG评分的减少呈纵向相关性（r = 0.6107，P <0.01）。 DFPP和IA均显示出比免疫球蛋白输注更好的短期临床疗效，可快速有效地清除晚期MG患者（尤其是Titin-ab）的病原性抗体。

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