利妥昔单抗对视神经脊髓炎患者视力及复发率的影响  

Effect of rituximab on visual acuity and recurrence rate in patients with neuromyelitis optica

作　　者：谢帆[1] 钟真真[1] 徐平[1] Xie Fan;Zhong Zhenzhen;Xu Ping(Department of Neurology,the First People's Hospital of Changde City,Hunan Province,Hunan Changde 415000)

机构地区：[1]湖南省常德市第一人民医院神经内科,湖南常德415000

出　　处：《中国社区医师》2021年第18期65-66,共2页Chinese Community Doctors

摘　　要：目的:探讨利妥昔单抗对视神经脊髓炎患者视力及复发率的影响。方法:2018年6月-2020年6月收治视神经脊髓炎患者40例,均采取利妥昔单抗治疗,连续诱导治疗4周,6~12个月后重复诱导治疗。比较患者治疗前后视力相关指标水平,年复发率(ARR)、残疾状态量表(EDSS)评分,并记录不良反应情况。结果:治疗后,患者最差眼平均logMAR矫正视力、最佳眼平均logMAR矫正视力、平均logMAR矫正视力均较治疗前明显下降,差异有统计学意义(P<0.05);治疗后,患者EDSS评分与ARR均较治疗前明显下降,差异有统计学意义(P<0.05);随访研究显示,治疗后患者出现疲倦嗜睡1例、心慌1例、呼吸困难2例、头痛3例、皮疹2例、脱发4例、胸闷5例、继发感染6例,均加用地塞米松,减缓利妥昔单抗滴速,对症治疗后明显好转。结论:对视神经脊髓炎患者采取利妥昔单抗治疗的效果良好,可有效改善患者视力,降低年复发率,且不良反应少,安全性高。Objective:To explore the effect of rituximab on visual acuity and recurrence rate in patients with neuromyelitis optica.Methods:From June 2018 to June 2020,40 patients with neuromyelitis optica were selected and treated with rituximab for 4 weeks.The induction therapy was repeated after 6~12 months.We compared the level of vision related indicators,annual recurrence rate(ARR),disability status scale(EDSS)score before and after treatment,and recorded the adverse reactions.Results:After treatment,the average LogMAR corrected visual acuity of the worst eye,the average LogMAR corrected visual acuity of the best eye,the average LogMAR corrected visual acuity were significantly lower those that before treatment,the difference was statistically significant(P<0.05).After treatment,EDSS score and ARR were significantly decreased compared with before treatment,the difference was statistically significant(P<0.05).The follow-up study showed that after treatment,there were 1 case of fatigue and drowsiness,1 case of palpitation,2 cases of dyspnea,3 cases of headache,2 cases of rash,4 cases of alopecia,5 cases of chest tightness and 6 cases of secondary infection,all the patients were improved obviously,after plus dexamethasone,slowing down the dripping rate of rituximab and symptomatic treatment.Conclusion:The effect of rituximab on patients with neuromyelitis optica is good,it can effectively improve the vision of patients,reduce the annual recurrence rate,with less adverse reactions and high safety.

关 键 词：利妥昔单抗 视神经脊髓炎 视力 年复发率 

分 类 号：R744.52[医药卫生—神经病学与精神病学]