大剂量甲基维生素B_(12)治疗多发性硬化急性期的疗效观察  

Effect of High Dose of Methyl-vitamin B_(12) in the Treatment of Patients with Multiple Sclerosis in Acute Phase

作　　者：屈新辉[1] 张昆南[1] 龚凌云[1] 高幼奇[1] 吴晓牧[1] 

机构地区：[1]江西省人民医院神经内科,南昌330006

出　　处：《实用临床医学（江西）》2008年第5期30-33,共4页Practical Clinical Medicine

摘　　要：目的探讨大剂量甲基维生素B12对复发缓解型多发性硬化( MS)急性期的疗效。方法 72例随机分为甲泼尼龙加大剂量甲基维生素B12组36例(观察组)及甲泼尼龙组36例(对照组) ,比较2组的有效率、治疗前后扩充致残量表(EDSS)平均评分及神经电生理包括体感诱发电位(SEP)、脑干听觉诱发电位(BAEP)、视觉诱发电位(VEP)的变化。结果治疗7 d时2组治疗前后EDSS评分均显著降低(均P<0 .001) ,有效率对照组为69 .4 %、观察组为75 .0 %,比较2组有效率和治疗后EDSS评分均无显著性差异(均P>0 .05)。治疗30 d时观察组有效率为97 .2 %,明显高于对照组的77 .7 %(P<0 .05) ;观察组EDSS评分也较对照组明显降低(P<0 .05)。诱发电位在治疗7 d时2组总的改善率无差别(P>0 .05) ,在治疗30 d时2组有显著性差异(P<0 .05) ,尤其在VEP、BAEP改善明显(P<0 .01)。结论甲泼尼龙加用大剂量甲基维生素B12治疗急性期多发性硬化,能提高有效率,促进神经功能的恢复,且长程使用效果可能更佳。大剂量甲基维生素B12可以作为免疫抑制治疗急性期多发性硬化的辅助治疗。Objective To assess the therapeutic effect of high dose of methyl-vitamin B12 in the treatment of relapsing-remitting multiple sclerosis （MS） in acute phase. Methods 72 cases with relapsing-remitting MS in acute phase were randomized into observation group （treated with methylprednisolone and methyl-vitamin B12 ） （n= 36） and control group （treated only with meth- ylprednisolone） （n= 36）, then the precent of effections, the average score of extended disability status scale （EDSS） and the change of neurological electrophysiology including somatosensory evoked potential （SEP） ,brain stem auditory evoked potential（BAEP） and visual evoked potential （VEP）were contrasted post-treatment between the two group. Results Contrast to pretherapy, the score of EDSS of two groups significantly decreased（P〈0. 001）, the precent of effections were respectively 69.4%（control group）and 75.0% observation group） but both had no significant difference（P〉0.05） after 7 days＇ treatment. However, after 30 days＇ treatment , the precent of effections of observation group （97.2 %） were obviously higher than control group （77.7%） （p 〈0.05）and the score of EDSS of observation group were obviously lower than control group （P 〈0.05）. The improvement rate of evoked potential（EP） of two groups had no significant difference（P〉0.05）after 7 days＇ threatment, but had significant difference （P〈0.05） after 30 days＇ treatment,especially in VEP and BAEP（P〈0.01）. Conclusion High dose of methyl-vitamin B12 with methylprednisolone can raise the orecent of effections,imorove the clinical symptom,and the therapeutic effect may be better with long-term administration in the treatment of MS patients in acute phase. High dose of methyl-vitamin B12 can be used as adjunctive therapy for the immunosuppressive therapy to MS in acute phase.

关 键 词：多发性硬化 治疗 甲基维生素B12 甲泼尼龙 

分 类 号：R744.51[医药卫生—神经病学与精神病学]