单独的血交换与静脉注射免疫球蛋白/甲基普雷迪尼索隆脉冲疗法的组合在严重的全身性类风湿性疾病中:一项回顾性研究
Jing Guo1,2,3, Shuiwen Li1,2,3, Hao Xu1,2,3
1Department of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.
Frontiers in immunology
|January 17, 2025
概括
在治疗性血交换 (TPE) 中添加静脉注射免疫球蛋白 (IVIG) 或静脉注射甲基prednisolone脉冲 (IVMP) 并没有改善严重系统性类风湿性疾病 (SRD) 的结果. 这些发现表明,对SRDs可能不需要组合治疗.
科学领域:
- 类风湿病学 类风湿病学
- 密集护理医学 密集护理医学
- 免疫学 免疫学 免疫学
背景情况:
- 严重的全身性风湿性疾病 (SRD) 有时需要治疗性血交换 (TPE) 作为救援疗法.
- TPE通常与静脉注射免疫球蛋白 (IVIG) 或静脉注射甲基前尼索隆脉冲 (IVMP) 结合使用,但这种结合方法的必要性尚不确定.
研究的目的:
- 评估单独TPE与与IVIG/IVMP结合的TPE在治疗严重SRD患者中的有效性.
- 为了比较两种治疗策略之间的临床结果,包括死亡率和ICU停留时间.
主要方法:
- 一项回顾性研究包括91名在2011年1月至2019年12月期间入住ICU的严重SRD患者.
- 患者被分为单独TPE组 (n=51) 和TPE加IVIG/IVMP组 (n=40).
- 评估的结果包括临床特征,序列器官衰竭评估得分,28天死亡率和ICU停留时间.
主要成果:
- 与TPE单独组相比,TPE加IVIG/IVMP组的感染率明显高 (P<0.05).
- 在28天死亡率或ICU停留时间 (P > 0.05) 中没有观察到群体之间的统计学上显著差异.
结论:
- 将IVIG/IVMP与TPE结合使用似乎不会为患有严重SRD的患者提供额外的益处.
- 这些发现表明,IVIG/IVMP可能不是TPE在严重SRDs管理中的必要补充.
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