他克莫司治疗慢性炎性脱髓鞘性多发性神经根神经病的疗效  

Efficacy of tacrolimus in the treatment of chronic inflammatory demyelinating polyradiculoneuropathy

作　　者：聂湘涛 黄根 马永博 朱哥可 郭秀明[1] NIE Xiangtao;HUANG Gen;MA Yongbo;ZHU Geke;GUO Xiuming(The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院,重庆400016

出　　处：《中国实用神经疾病杂志》2023年第4期397-402,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 对比他克莫司与糖皮质激素用于慢性炎性脱髓鞘性多发性神经根神经病(CIDP)维持治疗的临床疗效。方法 收集2019-05—2021-10在重庆医科大学附属第一医院神经内科住院治疗的CIDP患者32例,分为他克莫司治疗组(观察组)与激素治疗组(对照组)。通过对2组患者维持治疗前后反映疾病严重程度的专科量表[包括评估损伤的英国医学研究委员会(MRC)量表、评估残疾的炎症性Rasch综合残疾量表(I-RODS)]得分进行分析,观察他克莫司治疗CIDP的疗效。结果 两因素重复测量设计的方差分析显示,在时间因素和组别因素无交互作用的情况下(P>0.05),时间因素对两量表的主效应差异均有统计学意义(P<0.05),且两量表得分均随时间呈上升趋势(P<0.05)。2组患者在开始维持治疗后第3、6、12个月两量表得分差异均无统计学意义(P>0.05)。为期1 a的观察试验结束时,2组患者改善率及复发率差异均无统计学意义(P>0.05)。结论 无论他克莫司还是糖皮质激素作为CIDP的维持治疗均能使患者获益,且他克莫司用于CIDP维持治疗的疗效不劣于糖皮质激素。Objective To compare the clinical efficacy of tacrolimus versus glucocorticoids in maintenance treatment of chronic inflammatory demyelinating polyradiculoneuropathy.Methods A total of 32 patients with CIDP who were hospitalized in the Department of Neurology,the First Affiliated Hospital of Chongqing Medical University from May 2019 to October 2021 were collected and divided into tacrolimus treatment group(observation group)and hormone treatment group(control group).The scales(including MRC scale to assess injury and I-RODS scale to assess disability)reflecting disease severity before and after maintenance treatment in two groups were statistically analyzed to preliminarily explore the efficacy of tacrolimus in the treatment of CIDP.Results The variance results of repeated measures of two factors showed that in the case of no interaction between time factors and group factors(P>0.05),the main effects of time factors on MRC and I-RODS scales were statistically significant(P<0.05),and the scores of the two scales showed an upward trend with time(P<0.05).At the3rd,6th and 12th month after maintenance treatment,there was no significant difference in the scores of the two scales between the two groups(P>0.05).At the end of the 1-year observation trial,there were no significant difference in the improvement rate or recurrence rate between the two groups(P>0.05).Conclusion Either tacrolimus or glucocorticoid as maintenance treatment can benefit CIDP patients,and the efficacy of tacrolimus in CIDP maintenance treatment is not inferior to that of glucocorticoid.

关 键 词：慢性炎性脱髓鞘性多发性神经根神经病 他克莫司 糖皮质激素 维持治疗 激素治疗 

分 类 号：R741.05[医药卫生—神经病学与精神病学]