小剂量利妥昔单抗序贯治疗视神经脊髓炎谱系疾病的临床疗效观察  

Clinical Observation on Low-dosage Rituximab in the Sequential Treatment of Neuromyelitis Optica Spectrum Disorders

作　　者：贾晓涛[1] 顾乃兵[1] 刘志勤[1] 狄政莉[1] 潘艳芳[2] Jia Xiaotao;Gu Naibing;Liu Zhiqin;Di Zhengli;Pan Yanfang(Xi′an Central Hospital,Xi′an Jiaotong University,Xi′an 710003,Shannxi,China)

机构地区：[1]西安交通大学附属西安市中心医院,西安710003 [2]陕西中医药大学

出　　处：《中西医结合心脑血管病杂志》2018年第22期3256-3258,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金青年项目(No.81703842);陕西省重点研发计划项目(S2018-YF-YBSF-0293)

摘　　要：目的探究小剂量利妥昔单抗序贯治疗视神经脊髓炎谱系疾病的有效性和安全性。方法选取2014年2月—2018年1月西安市中心医院神经内科收治的视神经脊髓炎谱系疾病病人18例,随机分为对照组和试验组,各9例。对照组给予琥珀酸甲泼尼龙1 000mg静脉输注冲击治疗,逐渐减量;联合静脉注射大剂量免疫球蛋白治疗0.4g/(kg·d),连续5d;试验组在对照组基础上予利妥昔单抗100mg,1次/周,连用4周,6个月～12个月后重复应用。比较两组临床扩展致残量表(EDSS)评分、年复发率(ARR)及不良反应情况。结果试验组EDSS评分差值明显高于对照组(P <0.05);试验组治疗前后ARR存在明显差异(P <0.05),且治疗后试验组ARR明显低于对照组(P <0.05)。结论小剂量利妥昔单抗序贯治疗在视神经脊髓炎谱系疾病缓解期治疗中有明显疗效,且未见明显不良反应。Objective To investigate the efficacy and safety of low dose of rituximab in sequential treatment of neuromyelitis optica spectrum disorders.Methods Eighteen patients with neuromyelitis optica spectrum disorders were admitted the Department of Neurology in Xi′an Central Hospital from February2014to January2018.All patients were randomly divided into control group(9cases)and treatment group(9cases).Patients in the control group were administered with methyl succinate methylprednisolone1000mg pluse therapy by intravenous drip,then gradually reduce the dose,and combined with high dose immunoglobulin treatment0.4g/(kg.d)by intravenous injection.Patients in the treatment group were administered rituximab with the dose of100mg once week,for4weeks,on the basis of the control groups.Expanded Disability Status Scale(EDSS)score,annual recurrence rate(ARR),and adverse reactions were observed after6to12months.Results EDSS scores difference in the treatment group were significantly higher than those in the control group(P<0.05).There was significant difference in ARR before and after treatment in the treatment group(P<0.05).After treatment,ARR in the treatment group was significantly lower than that in the control group(P<0.05).Conclusion Sequential treatment with low dose rituximab has a significant effect in the remission stage of neuromyelitis optica spectrum disorders,and no obvious side effects was found.

关 键 词：视神经脊髓炎谱系疾病 利妥昔单抗 年复发率 临床扩展致残量表 不良反应 有效性 安全性 

分 类 号：R774.5[医药卫生—眼科]