干扰素β-1b对再发缓解型多发性硬化患者脑萎缩影响的MRI定量评估(英文)  

Quantitative evaluation of influences of interferon beta-1b on brain atrophy in relapsing-remitting multiple sclerosis patients with magnetic resonance imaging

作　　者：王江桥[1] 索爱琴[1] 郝琦 齐田孝彦 

机构地区：[1]河南省人民医院神经内科,河南省郑州市450003 [2]京都宇多野病院神经内科神经疾病研究中心

出　　处：《中国组织工程研究与临床康复》2007年第8期1585-1588,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:核磁共振成像的定量测量已被广泛用于评估多发性硬化症的治疗效果。目的:确定是否干扰素β-1b对多发性硬化脑萎缩的影响能通过MRI测量表达出来。设计:随机对照观察。单位:日本京都宇多野病院神经疾病研究中心。对象:选择1998-01/12在在日本京都宇多野病院神经疾病研究中心收治的188例多发性硬化患者,男55例,女133例,年龄16～59岁,平均(36±11)岁。纳入标准:①按poser再发缓解型诊断标准临床确诊为多发性硬化。②扩展残疾状况评分表得分≤7分。③在过去的1年中至少1次复发,或在就诊之前的2年间有至少2次复发,但就诊前30d无复发,神经系统体征稳定至少1个月,干扰素β-1b皮试阴性。④均对检测项目知情同意。纳入患者中,视神经脊髓型148例,经典型50例。方法:①药物治疗:所有患者给予干扰素β-1b注射剂,根据注射剂量不同将患者分为低剂量组(n=93)和高剂量组(n=95),分别给予160万U和800万U隔日干扰素β-1b注射剂皮下注射,共使用2年。②磁共振扫描检查:对所有患者包括病灶的部位(视神经、大脑、小脑、脑干和脊髓)进行磁共振扫描,T1和T2加权轴面磁共振检查由同一神经病学家评估,T2加权像病灶面积是逐层相加计算出总面积以mm2表示,检查指标为第三脑室、侧脑室宽度、脑宽度进行测量,结果采用萎缩率表示。③神经功能缺损检查:采用Kurtzke扩展残疾状况评分表(从0分到10分,0分为正常,分数越高病情越严重)评估。④相关因素分析:对148例典型多发性硬化患者脑萎缩情况和T2病灶面积和扩展残疾状况评分表得分变化两项因素进行相关性分析,同时对起始时变量(年龄,病程,复发率,T2病灶面积和扩展残疾状况评分表得分)和脑萎缩情况进行相关性分析。主要观察指标:①两组患者脑萎缩情况比较。②脑萎缩测量相关因素分析。结果:纳入198例患者全部进入结果�BACKGROUND： The quantitative measurements based on magnetic resonance imaging （MRI） have been vastly used in evaluating the therapeutic efficacy on multiple sclerosis （MS）. OBJECTIVE： To determine whether the effect of IFNB-1b on brain atrophy of MS could be shown with analysis of MR measurement. DESIGN： Randomized controlled observation. SETTING ： Center for Neurological Diseases, Utano National Hospital. PARTICIPANTS ： Totally 188 patients with MS, including 55 males and 133 females aged from 16-59 years, averagely （36±11） years, from Center for Neurological Diseases, Utano National Hospital from January to December 1996 were enrolled. Inclusive criteria： ①according to Poser RR type criteria were considered as having MS for enrollment, ②Expanded Disability Status Scale （EDSS） score of 7.0 or less, ③at least 1 relapse in the past year or at least 2 relapses in the past two years prior to enrollment, but no relapse for 30 days before enrollment, stable neurological state for at least 1 month and negative results of the IFNB-1b needle-prick test, and ④they all knew the detected items and agreed. In the included patients, there were 148 cases of optic nerves and spinal cord type and 40 cases of classical type. METHODS： ①Drug treatment： All the patients were treated with IFNB-1b injectable preparation （provided by Japanese Pharmaceuticals Company）. According to the different injected dosage, the patients were divided into low-dosage group （n =93） and high-dosage group （n =95）, given with 1.6 million U and 8 million U of IFNB-lb subcutaneously on alternate days for 2 years. ②MRI examination： The patients received MRI in lesion site （optic nerves, cerebrum, cerebellum, brainstem, and spinal cord）. T1 and T2-weighted axial MRI scan were performed by a single neurologist. The area of the MS lesions in T2-weighted images was summed slice by slice for a total lesion area and was recorded as mm^2. Third ventricle,, lateral ventricle width and brain wi

关 键 词：多发性硬化 磁共振成像 干扰素Β 脑 萎缩 

分 类 号：R744.5[医药卫生—神经病学与精神病学]