利妥昔单抗对视神经脊髓炎患者视力及肠道菌群的影响分析  

Effects of Rituximab on Visual Acuity and Intestinal Flora in Patients with Neuromyelitis Optica

作　　者：李邦静 陈睿 王瑞 LI Bangjing(West China Hospital,Sichuan University,Sichuan Chengdu 610041,China)

机构地区：[1]四川大学华西医院神经内科,四川成都610041 [2]四川省人民医院全科医学中心,四川成都610000 [3]四川省荥经县人民医院,四川荥经625000

出　　处：《河北医学》2023年第3期507-511,共5页Hebei Medicine

基　　金：四川省卫生厅科研课题,(编号:150161)。

摘　　要：目的:探讨利妥昔单抗对视神经脊髓炎患者视力及肠道菌群的影响。方法:选择我院2018年3月至2021年3月收治的127例视神经脊髓炎患者进行研究,采用随机数字表通过简单随机的方法将其分为研究组(n=64)与对照组(n=63),两组在急性期均给予激素冲击治疗,研究组在缓解期给予利妥昔单抗治疗,对照组缓解期给予环磷酰胺静滴治疗,在治疗前和治疗8周后,采用扩展残疾状况评分量表(EDSS)评定治疗效果,比较两组治疗前和治疗8周后的视力、肠道菌群分布情况,比较治疗期间不良反应发生情况,本研究随访1年,比较两组复发情况。结果:两组治疗后各EDSS子项目功能均较本组治疗前恢复明显(P<0.05),研究组治疗前后锥体系功能、脑干功能、膀胱直肠功能、视觉功能评分差值高于对照组(P<0.05),两组治疗后最差眼、最佳眼以及平均logMAR矫正视力,数值均明显低于治疗前(P<0.05),研究组治疗前后差值高于对照组(P<0.05),复发率低于对照组(P<0.05)。治疗后Chaol指数以及Shannon指数分别为(233.15±15.26)和(3.36±0.68),均高于对照组治疗后(P<0.05),两组不良反应比较,差异无统计学意义(P>0.05)。结论:利妥昔单抗提升视神经脊髓炎患者的视力和改善肠道菌群结构具有明显作用,具有推广应用的价值。Objective:To investigate the effect of rituximab on vision and intestinal flora in patients with neuromyelitis optica.Methods:A total of 127 patients with neuromyelitis optica admitted to our hospital from March 2018 to March 2021 were selected for research,and they were divided into a study group(n=64)and a control group(n=63)by a simple random method using a random number table.Both groups were given hormone pulse therapy in the acute phase,the study group was given rituximab therapy in the remission phase,and the control group was given cyclophosphamide intravenous infusion therapy in the remission phase.The Disability Status Scale(EDSS)was used to evaluate the treatment effect.The visual acuity and intestinal flora distribution before and after 8 weeks of treatment were compared between the two groups,and the incidence of adverse reactions during the treatment was compared.The study was followed up for 1 year to compare the recurrence of the two groups.Results:After treatment,the function of EDSS subitems in the two groups recovered significantly compared with that before treatment(P<0.05).The differences of cone system function,brain stem function,vesicorectal function and visual function scores in the study group before and after treatment were higher than those in the control group(P<0.05).The worst eye,the best eye and the average logMAR corrected visual acuity after treatment in the two groups.The difference before and after treatment in the study group was higher than that in the control group(P<0.05),and the recurrence rate was lower than that in the control group(P<0.05).After treatment,the Chaol index and Shannon index were(233.15±15.26)and(3.36±0.68),respectively,which were higher than those of the control group(P<0.05),and there was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Rituximab has obvious effects on improving vision and intestinal flora structure in patients with neuromyelitis optica,and has the value of popularization and application.

关 键 词：利妥昔单抗 视神经脊髓炎 视力 肠道菌群 安全性 

分 类 号：R744.52[医药卫生—神经病学与精神病学]