冷凝球蛋白血症之簡介與護理

Abstract

冷凝球蛋白是一群遇冷、低於正常體溫（小於攝氏37度）即產生沈澱、凝集之免疫球蛋白，當血液中出現冷凝球蛋白即稱為冷凝球蛋白血症。冷凝球蛋白血症可能造成皮膚出現紫斑、周邊神經病變、關節疼痛、增生性腎臟炎、血液高度黏稠症候群和全身性冷凝球蛋白血管炎等並依不同型態而呈現多種臨床症狀，亦可能導致重症症狀如急性腎衰竭、影響呼吸及中樞神經系統之功能。本文藉由介紹冷凝球蛋白血症的臨床症狀、診斷與治療以及其患者可能面臨的健康問題，由護理的角度討論冷凝球蛋白血症患者其在照護上的重點與相關護理措施，期望提供臨床護理人員有關冷凝球蛋白血症之相關資訊，在臨床上照顧冷凝球蛋白血症患者時可以充實背景知識，進而提升護理照護品質。

This article introduced the clinical symptom, diagnosis, treatment and the associated health problem, further discussed the nursing care and intervention on patients with cryoglobulinemia. Cryoglobulins are immunoglobulins that participate and crystalise at temperatures below normal body temperature (＜ 37°C). Cryoglobulinemia is defined as entity characterized by the presence of cryoglobulins in the serum. The clinical manifestations of cryoglobulinemia are broad and vary between types, but include orthostatic purpura, peripheral neuropathy, arthralgia, proliferative glomerulonephritis, hyperviscosity syndrome, and cryoglobulinemic vasculitis. Life-threatening manifestations and critical illness such as acute renal failure, pulmonary and central nervous system involvement can also develop in patients with cryoglobulinemia. This review provides updated information for nurses and the presented information that may help in promoting the quality of nursing care.