依库珠单抗对水通道蛋白4抗体阳性视神经脊髓炎谱系疾病急性发作的疗效  

Efficacy and safety of eculizumab on acute attacks in patients with aquaporin-4 antibody positive neuromyelitis optica spectrum disorder

作　　者：吕明星 曲美洁 荣溪 赵允彬 孙绪鹏 王俪 刘敏[1] Lyu Mingxing;Qu Meijie;Rong Xi;Zhao Yunbin;Sun Xupeng;Wang Li;Liu Min(Department of Neurology,the Affiliated Hospital of Qingdao University,Qingdao 266005,China)

机构地区：[1]青岛大学附属医院神经内科,青岛266005

出　　处：《中华行为医学与脑科学杂志》2025年第2期146-150,共5页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的观察依库珠单抗治疗水通道蛋白4抗体(AQP4-IgG)阳性视神经脊髓炎谱系疾病(NMOSD)急性发作患者的疗效和安全性。方法研究纳入了2023年8月至2024年4月在青岛大学附属医院接受依库珠单抗治疗的6例AQP4-IgG阳性NMOSD患者,记录患者的临床特征、治疗前后神经功能、疼痛和痉挛评分变化、治疗期间的药物不良反应。采用SPSS 25.0对数据进行描述性分析和Friedman检验。结果6例患者治疗前扩展残疾状态量表(EDSS)中位数为3.25分,依库珠单抗治疗后EDSS评分中位数降至1.25分,差异有统计学意义(F=44.77,P<0.01),系统功能评分在治疗第1周即出现变化,对治疗效果的反应更为敏感;3例治疗前存在中重度疼痛,疼痛评分均数6分,治疗后第2和6周分别降至4.67分、1.33分,改善明显(F=29.17,P<0.05);2例患者治疗前出现痉挛,评分均数3.00分,治疗后第2、3、6周分别降至2.00分、1.50分、1.00分,症状改善不显著(F=18.00,P>0.05)。治疗期间未观察到严重不良反应。结论依库珠单抗能改善AQP4-IgG阳性NMOSD急性发作患者的神经功能、缓解疼痛,并且具有良好的安全性。ObjectiveTo evaluate the efficacy and safety of eculizumab in treating acute attacks of aquaporin-4 antibody(AQP4-IgG)positive neuromyelitis optica spectrum disorder(NMOSD).MethodsSix patients with AQP4-IgG-positive NMOSD treated with eculizumab at the Affiliated Hospital of Qingdao University from August 2023 to April 2024 were included.The patients'clinical characteristics,changes in scores of neurological function,pain and spasm before and after eculizumab treatment,and adverse drug reactions during the treatment period were described,and the data were subjected to Friedman test using SPSS 25.0.ResultsThe median score of expanded disability status scale in the six patients decreased from 3.25 before treatment to 1.25 after treatment,and the difference was statistically significant(F=44.77,P<0.01).The functional status score showed noticeable improvement as early as week 1,demonstrating greater sensitivity to treatment response.Three patients experienced moderate to severe pain before treatment,with a mean pain score of 6,which reduced to 4.67 and 1.33 at week 2 and 6,respectively(F=29.17,P<0.05).Two patients reported spasms before treatment,with a mean score of 3.00,which decreased to 2.00,1.50,and 1.00 at week 2,3,and 6 after treatment,respectively(F=18.00,P>0.05).No serious adverse reactions were reported during the treatment.ConclusionEculizumab can effectively improve the neurological function and alleviate pain in patients with AQP4-IgG-positive NMOSD during acute attacks,and demonstrate good safety.

关 键 词：视神经脊髓炎谱系疾病 急性发作 依库珠单抗 水通道蛋白4抗体 

分 类 号：R74[医药卫生—神经病学与精神病学]