慢性炎症性脱髓鞘性多发性神经病变的长期预后:一项包括38例患者的5年随访研究  

Long term prognosis of chronic inflammatory demyelinating polyneuropathy: A five year follow up of 38 cases

作　　者：Kuwabara S. Misawa S. Mori M. 王鹏(译) 

机构地区：[1]Department of Neurology, Graduate School of Medicine, Chiba University, 1 -8-1, Inohana, Chuo-ku, Chiba, 2608670, Japan [2]不详

出　　处：《世界核心医学期刊文摘（神经病学分册）》2006年第5期47-48,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background: Little is known about long term prognosis and course after immune treatments in chronic inflammatory demyelinating polyneuropathy (CIDP). Objective: To study long term outcomes and prognostic factors in patients with CIDP. Methods: Clinical and electrophysiological findings, responses to immune modulating treatments, and outcomes five years after the start of treatment were reviewed in 38 CIDP patients. Results: Patients were treated with corticosteroids (89% ), immunoglobulin infusion (45% ), or plasmapheresis (34% ), and 58% received combined therapy. Five years after treatment was begun, 10 (26% ) of the patients had complete remission (lasting >2 years with normal nerve conduction studies), and 23 (61% ) had partial remission (able to walk) with (26% ) or without (34% ) immune treatments. The remaining five patients (13% ) still had severe disability (unable to walk) or treatment dependent relapses. Patients with complete remission more often had subacute onset, symmetrical symptoms, good response to initial corticosteroid treatment, and nerve conduction abnormalities predominant in the distal nerve terminals. In contrast, insidious onset, asymmetrical symptoms, and electrophysiological evidence of demyelination in the intermediate nerve segments were associated with refractoriness to treatment or treatment dependent relapse. Conclusions: The long term prognosis of CIDP patients was generally favourable, but 39% of patients still required immune treatments and 13% had severe disabilities. Mode of onset, distribution of symptoms, and electrophysiological characteristics may be prognostic factors for predicting a favourable outcome.Background： Little is known about long term prognosis and course after immune treatments in chronic inflammatory demyelinating polyneuropathy （CIDP） Objective： To study long term outcomes and prognostic factors in patients with CIDP. Methods： Clinical and electrophysiological findings, responses to immune modulating treatments, and outcomes five years after the start of treatment were reviewed in 38 CIDP patients. Results： Patients were treated with corticosteroids （89%）, immunoglobulin infusion （45%）, or plasmapheresis （34%）, and 58% received combined therapy. Five years after treatment was begun, 10 （26%）of the patients had complete remission （lasting 〉 2 years with normal nerve conduction studies）, and 23 （61%） had partial remission （able to walk） with （26%） or without （34%） immune treatments. The remaining five patients （13%） still had severe disability （unable to walk） or treatment dependent relapses. Patients with complete remission more often had subacute onset, symmetrical symptoms, good response to initial corticosteroid treatment, and nerve conduction abnormalities predominant in the distal nerve terminals. In contrast, insidious onset,

关 键 词：多发性神经病变 长期预后 脱髓鞘性 炎症性 患者 随访研究 慢性 皮质激素治疗 免疫治疗 治疗依赖性 

分 类 号：R59[医药卫生—内科学] R726.573[医药卫生—临床医学]