【摘要】 目的探讨免疫吸附法(Immunoadsorption,IA)治疗多发性硬化(multiple sclerosis,MS)的临床疗效和不良反应。方法将该院神经内科收治的多发性硬化患者43例随机分为两组,观察组22例,对照组21例,观察组在常规治疗的基础上采用IA治疗,对照组采用传统治疗,疗程4周,比较两组患者治疗后神经功能的恢复程度(EDSS评分)、不良反应,以及血浆免疫球蛋白(IgG,IgA,IgM)、补体C3、脑脊液寡克隆区带(CSF-OB)的改变情况。结果两组MS患者于治疗4周后神经功能均有不同程度的恢复,总有效率均达90%以上,观察组显效率(68.18%)比对照组(38.10%)更为明显,差异有统计学意义(P<0.05);观察组治疗后血浆免疫球蛋白和补体C3明显降低(P<0.01),与对照组比较差异有统计学意义(P<0.01),而对照组的变化不明显,差异无统计学意义(P>0.05);治疗前两组MS患者的总体CSF-OB阳性率为32.56%,治疗后总体CSF-OB阳性率为23.26%,差异无统计学意义(P>0.05)。结论免疫吸附法能显著降低MS患者血浆免疫球蛋白和补体C3水平,有效恢复多发性硬化患者受损的神经功能,不良反应少,优于传统的药物治疗,值得临床借鉴。更多还原

【Abstract】 Objective: To investigate the clinical efficacy and adverse reactions to immunoadsorption(IA) in treatment of multiple sclerosis(MS). Methods: 43 cases neurology patients with multiple sclerosis have ever hospitalized in our hospital were collected and randomly divided into two groups, 22 cases in the observation group,21 cases in the control group,the observation group received IA treatment on the basis of conventional therapy,the control group received conventional therapy,treatment for 4 weeks,to compare two groups of patients the degree of recovery of neurological function(EDSS score),adverse reactions, and change of the plasma immunoglobulin(IgG,IgA,IgM),complement C3,oligoclonal bands in cerebrospinal fluid(CSF-OB)。 Results: MS patients in both groups after 4 weeks of treatment varying degrees of neurological recovery, the total efficiency of over 90%, the significant efficiency of the observation group(68.18%) was significantly more than the control group(38.10%), the difference was statistically significant(P <0.05); After treatment,the plasma immunoglobulins and the complement C3 of the observation group was significantly lower(P<0.01), compared with the control group, the difference was statistically significant(P <0.01), the control group did not change significantly(P>0.05); Before treatment the overall CSF-OB positive rate of 32.56% of the MS patients in both groups,after treatment the overall CSF-OB-positive rate was 23.26%, the difference was not statistically significant(P> 0.05). Conclusion:To the treatment of patients with MS,immunoadsorption can significantly reduce the plasma immunoglobulins and the complement C3 levels,effectively recover damaged nerve function,seldom adverse reactions,superior to conventional drug therapy,is worthy of reference。更多还原