Therapeutic Efficacy Of Plasma Exchange In Acute Attacks Of Multiple Sclerosis

Background:Multiple Sclerosis is an autoimmune disease characterized by demyelinating diseases of the central nervous system(CNS).The main clinical features of the disease are multiple spatial distribution of the lesions and multiple attacks.At present,there is no cure for MS,and immune therapy,plasma exchange and combination therapy are generally adopted.The first choice for the treatment of glucocorticoid therapy,and has been in our country and even global consensus.But,in the clinical work,we found that,in acute period,accounted for a certain proportion of patients with multiple sclerosis after glucocorticoid treatment were ineffective or invalid,then,in the early stage of treatment,can plasma exchange treatment improve the prognosis of patients? The purpose of this study was to compare the therapeutic effect of plasma exchange combined with glucocorticoid and glucocorticoid alone in patients with multiple sclerosis.Methods: Patients with multiple sclerosis in the acute stage of multiple sclerosis in **Hospital from September 2012 to January 2016 were collected.The criteria for the use of multiple criteria for diagnosis and treatment of multiple sclerosis in China(2010).On the impact of glucocorticoid therapy(intravenous methylprednisolone 1g * 5d)effect was not obvious(EDSS score after treatment improved <0.5 points),a total of 28 cases,male 8 cases,female 20 cases;age ranged from 16 to 66 years old,average 41.50 ± 12.72 years;the average duration of 1.3 years;the average acute during the period of onset time of 4.8 D.The subjects were divided into observation group and control group with 14 cases in each group.14 cases of patients in the control group were methylprednisolone intravenous injection,oral prednisolone tablets,the 14 patients in the observation group based on the treatment in control group,treated with plasma exchange in the treatment of large dose methylprednisolone after intravenous injection.After treatment,the clinical efficacy of the two groups was compared.Observation index: neurological dysfunction scale(EDSS)scores were compared between the two groups after the March nerve dysfunction scale(EDSS)scores and recurrence(and the new standard for clinical symptoms)adverse events compared two groups during treatment.The therapeutic effect to effective,effective and available as standard,the total efficiency(%)=(effective + effective)/ total number x 100%.Statistical analysis all the data were analyzed by statistical software SPSS17.0,all the data were expressed by X ± s,t test for statistical analysis of the differences between groups,test data using 2 test,P < 0.05 represent statistically significant.Results:After treatment of the two groups,(1)the total effective rate of observation group was 92.9%,total effective treatment in the control group 57.1%,observation group cure rate was significantly higher than the control group,there was statistical significance(P< 0.05);(2)the observation group after treatment EDSS decreased compared with the control group,there is a significant change was statistically significant(P< 0.05);(3)nerve dysfunction scale in the two groups after March(EDSS)scores were statistically significant(P< 0.05),but the clinical recurrence rate was not statistically significant(P>0.05)(4)The two groups of patients had no severe adverse reactions,no statistical significance(P>0.05).Conclusions: This study further shows that plasma exchange therapy is effective,necessary and safe in the treatment of patients with glucocorticoid hormone therapy.