甲基强的松龙鞘内注射治疗急性期多发性硬化的临床疗效及其对患者T淋巴细胞亚群的影响  

Efficacy of intrathecal injection of methylprednisolone in treatment of multiple sclerosis and its effect on T-lymphocyte subsets

作　　者：董艳玲[1] 李吕力[1] 李瑶宣[1] 梁浩[1] 滕晓茗[1] 

机构地区：[1]广西壮族自治区人民医院,南宁530021

出　　处：《山东医药》2014年第31期18-20,共3页Shandong Medical Journal

基　　金：广西科学研究与技术开发计划课题(桂科攻0898010);广西壮族自治区卫生厅科研课题(Z2008085)

摘　　要：目的观察鞘内注射甲基强的松龙(MPS)治疗急性期多发性硬化(MS)的效果及其对患者T淋巴细胞亚群的影响。方法将80例急性期MS患者随机分为鞘内注射组35例、冲击组45例,两组均常规应用营养神经药物,并分别予MPS鞘内注射及常规静脉注射冲击治疗。两组均于治疗前和治疗后2周采用流式细胞仪检测外周血和T淋巴细胞亚群水平,采用Kurtzke扩展致残量表(EDSS)进行神经功能评分(计算治疗前后评分差值ΔEDSS评分)。结果治疗后5 d时鞘内注射组ΔEDSS评分显著高于冲击组,P<0.05(t=17.516);治疗后10、15 d两组ΔEDSS评分比较,P均﹥0.05。与治疗前比较,两组治疗后脑脊液中CD+4细胞减少、CD+8细胞增多,外周血中CD+8细胞增多、CD+4/CD+8降低;两组治疗后T淋巴细胞亚群各指标比较均无显著差异(P均﹥0.05)。结论鞘内注射MPS可显著改善MS患者神经功能及调节T淋巴细胞亚群平衡,且起效较快。Objective To observe the efficacy of intrathecal injection of methylprednisolone （ MPS） in treatment of multiple sclerosis （ MS） and its effect on T-lymphocyte subsets .Methods Eighty patients with acute MS were divided into the MPS intrathecal injection group （35 cases） and MPS impact group （45 cases）.The two groups were treated with con-ventional neurotrophic drugs , and then were treated with intrathecal injection of MPS and conventional intravenous impact therapy .Flow cytometry was used to evaluate the levels of T-lymphocyte subsets and peripheral blood of the two groups be-fore and after treatment for 2 weeks.Then we evaluated the neurological scores by using Kurtzke expanded disability status scale （EDSS）.Results After treatment for 5 days, the ΔEDSS in the MPS intrathecal injection group was higher than that in the MPS impact group （t=17.516, P〈0.05）, but no difference was found between the two groups after treatment for 10 and 15 days （all P〉0.05）.The CD4＋decreased and CD8＋increased in cerebrospinal fluid （CSF）, and the CD4＋increased and the CD 4＋/CD8＋decreased in the peripheral blood of the two groups after treatment as compared with those be -fore treatment.The difference in the indexes of T-lymphocyte subsets was not statistical significant between the two groups after treatment （all P〉0.05）.Conclusions Intrathecal injection of MPS in treatment of MS works faster and the neuro-logical function improves better as compared with the MPS impact therapy .With the remission of the disease , there are dif-ferent degrees of improvement in the T-lymphocyte subsets .

关 键 词：多发性硬化 甲基强的松龙 鞘内注射 T淋巴细胞 

分 类 号：R744.5[医药卫生—神经病学与精神病学]