血浆置换在重症银屑病治疗中的疗效观察

目的：探讨血浆置换治疗重症银屑病的疗效。方法：入选患者均采用深静脉置管建立临时血液通路,置换总量1 800～2 200 ml/次,每周治疗1～2次根据患者皮损及症状改善情况连续4～6次不等。结果：9例患者经45例次血浆置换治疗后,血液中TNF-α、IL-1β、IL-6、IL-8、IgG、IgA促炎细胞因子和免疫球蛋白呈显著降低趋势。皮损明显好转,脓疱结痂、脱落,关节红、肿、疼痛消失,经药物使用逐渐减量治疗后病情好转。结论：血浆置换对重症银屑病是一种疗效快、疗程短的治疗方法,它能迅速清除体内的炎症介质及免疫复合物,有效地控制临床症状。

Treatment Efficacy of Plasma Exchange in Patients with Severe Psoriasis

Objective：To investigate treatment and nursing of plasma exchange in patients with severe psoriasis.Methods：Deep venous blood catheter had been set up in all selected patients.The total replacement volume was set between 1 800 ml to 2 200 ml each time.The therapeutic dose was adjusted once or twice a week.The total dose was ranging from 4～6 times according to the improvement situation of the symptoms and skin lesions.Results：After 45 times of plasma exchange treatment,the levels of immunoglobulin and cytokines like TNF-α.IL-1β.IL-6.IL-8,IgG and IgA all decreased,the skin lesions were relieved significantly in that the pustules formed a scab and fell off.The inflammation symptoms like reddening,swollenness and pain in the joint disappeared in 9 cases.After a gradual reduction of drug dose,all the 9 patients were gradually recovered and discharged.Conclusion：Plasma exchange was an effective and fast treatment for severe psoriasis,the inflammatory mediators and immune complexes can be rapidly cleared off.It is worthy of clinical wider application.