激素联合环磷酰胺治疗视神经脊髓炎谱系疾病:1例报告及文献复习  

Steroid combined with cyclophosphamide in neuromyelitis optica spectrum disorder:One case report and literature review

作　　者：孙传河 廖伟龙 高鹏琳 姜文斐[1] 潘卫东[1] 

机构地区：[1]上海中医药大学附属曙光医院脑病科,上海201203 [2]山东省滨州市中医院内二科,山东滨州256600

出　　处：《神经病学与神经康复学杂志》2017年第3期146-150,共5页Journal of Neurology and Neurorehabilitation

摘　　要：目的:报道激素联合环磷酰胺治疗视神经脊髓炎谱系疾病患者1例,并对相关文献进行复习。方法:对1例诊断为视神经脊髓炎谱系疾病患者进行相关实验室检查(包括水通道蛋白4)和辅助检查,并基于临床实践,给予激素联合环磷酰胺治疗。结果:该患者以渐进性右眼视物模糊伴右侧肢体无力、麻木起病,诊断为视神经脊髓炎谱系疾病。治疗方面,先给予激素冲击治疗,但患者病情不断进展且对激素产生依赖性,遂加用环磷酰胺,使患者的病情得到了有效控制。结论:对于视神经脊髓炎谱系疾病激素治疗不佳的患者,激素联合环磷酰胺治疗可以明显改善其临床症状。Objective: To report one patient diagnosed of neuromyelitis optica spectrum disorder(NMOSD) receiving treatment with steroid combined with cyclophosphamide, and review the related literatures.Methods: Laboratory examinations(including aquaporin-4 detection) and adjuvant examinations were performed on one patient with NMOSD, and the treatment with steroid combined with cyclophosphamide based on clinical practice was administrated.Results: The patient suffered from progressive blurred vision of the right eye, accompanied by the weakness and numbness of the right limb, and was diagnosed of NMOSD. For treatment, this patient received steroid pulse therapy immediately after the NMOSD was confirmed, but the patient's condition continued to progress and developed steroiddependence.Then the cyclophosphamide was added and the patient's condition was effectively controlled.Conclusion: There is a significant benefit in NMOSD patients who are treated with steroid combined with cyclophosphamide when the only steroid treatment is ineffective.

关 键 词：视神经脊髓炎谱系疾病 水通道蛋白4 类固醇 环磷酰胺 

分 类 号：R744.52[医药卫生—神经病学与精神病学]