利妥昔单抗治疗复发性眼球阵挛-肌阵挛综合征疗效分析  

The efficacy and follow-up of rituximab in opsoclonus myoclonus syndrome

作　　者：石伟伟 张敏[1] 刘方[1] 刘恒方[1] SHI Weiwei;ZHANG Min;LIU fang;LIU Hengfang(The Fifth Affilitated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2020年第23期2097-2101,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(编号:81901326)。

摘　　要：目的探讨利妥昔单抗对复发性眼球阵挛-肌阵挛综合征(OMS)的长期疗效。方法分析郑州大学第五附属医院神经内科经临床诊断为OMS患儿的临床特征,分别使用抗病毒+小剂量激素、人血丙种球蛋白+激素冲击、利妥昔单抗治疗,采用NIHSS评分量表评价3种治疗方案效果,并随访其治疗效果。结果患儿经抗病毒+小剂量激素治疗后,NIHSS评分均无改善,治疗效果不佳。患儿经过人血丙种球蛋白+激素冲击治疗后NIHSS评分有所改善,但治疗效果持续时间较短,复发频率较高,平均约23 d,需每月重复治疗。患儿给予利妥昔单抗4个疗程后,第一次用药期间发现患儿除有短暂发热、低血压外,未观察到其他不良反应,NIHSS评分改善显著,随访至今6个月未复发。结论对复发性眼球阵挛-肌阵挛综合征患儿,利妥昔单抗可能是一种安全、有效的治疗手段。Objective Explore the long-term efficacy of rituximab against recurrent opsoclonus-myoclonus syndrome(OMS).Methods Analysis of the clinical characteristics of children with opsoclonusmyoclonus syndrome,the childwas diagnosisedin Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University.The child was used theantiviral and hormone,the human blood propylene globulin-hormone,the rituxicytadetic therapy,respectively.NIHSS scoring scale was evaluated the effectiveness of thetherapeutic effect,and follow-up to its therapeutic effect.Results There was no improvement in NIHSS score after antiviral and hormone therapy.After human blood propylene and hormone therapy,the duration of therapeutic effect lasts about 23 days.Although the NIHSS score was improved before and after treatment,the treatment was repeatedfor monthly.After the rituximabtreatmentfor 4 courses,the child's symptoms were significantly improved.It founds that the child hadtransientfever symptomst,transient hypotension during the drug treatment.NIHSS score was improved significantly,the therapeutic effectfrom the first use of rituximab has not relapsed for 6 months.Conclusion For children with OMS,rituximab may be a safe and effective treatment,therefore we recommend the use of rituximab to treatment children with OMS.

关 键 词：复发眼球阵挛-肌阵挛综合征 利妥昔单抗 激素治疗 人血丙种球蛋白 儿童 

分 类 号：R74[医药卫生—神经病学与精神病学]