目的：观察鞘内注射甲基强的松龙（ MPS）治疗急性期多发性硬化（ MS）的效果及其对患者T淋巴细胞亚群的影响。方法将80例急性期MS患者随机分为鞘内注射组35例、冲击组45例，两组均常规应用营养神经药物，并分别予MPS鞘内注射及常规静脉注射冲击治疗。两组均于治疗前和治疗后2周采用流式细胞仪检测外周血和T淋巴细胞亚群水平，采用Kurtzke扩展致残量表（EDSS）进行神经功能评分（计算治疗前后评分差值ΔEDSS评分）。结果治疗后5 d时鞘内注射组ΔEDSS评分显著高于冲击组，P＜0．05（t＝17．516）；治疗后10、15 d两组ΔEDSS评分比较，P均﹥0．05。与治疗前比较，两组治疗后脑脊液中CD4＋细胞减少、CD8＋细胞增多，外周血中CD8＋细胞增多、CD4＋/CD8＋降低；两组治疗后T淋巴细胞亚群各指标比较均无显著差异（P均﹥0．05）。结论鞘内注射MPS可显著改善MS患者神经功能及调节T淋巴细胞亚群平衡，且起效较快。%Objective To observe the efficacy of intrathecal injection of methylprednisolone ( MPS) in treatment of multiple sclerosis ( MS) and its effect on T-lymphocyte subsets .Methods Eighty patients with acute MS were divided into the MPS intrathecal injection group (35 cases) and MPS impact group (45 cases).The two groups were treated with con-ventional neurotrophic drugs , and then were treated with intrathecal injection of MPS and conventional intravenous impact therapy .Flow cytometry was used to evaluate the levels of T-lymphocyte subsets and peripheral blood of the two groups be-fore and after treatment for 2 weeks.Then we evaluated the neurological scores by using Kurtzke expanded disability status scale (EDSS).Results After treatment for 5 days, the ΔEDSS in the MPS intrathecal injection group was higher than that in the MPS impact group (t=17.516, P<0.05), but no difference was found between the two groups after treatment for 10 and 15 days (all P>0.05).The CD4+decreased and CD8+increased in cerebrospinal fluid (CSF), and the CD4+increased and the CD 4+/CD8+decreased in the peripheral blood of the two groups after treatment as compared with those be -fore treatment.The difference in the indexes of T-lymphocyte subsets was not statistical significant between the two groups after treatment (all P>0.05).Conclusions Intrathecal injection of MPS in treatment of MS works faster and the neuro-logical function improves better as compared with the MPS impact therapy .With the remission of the disease , there are dif-ferent degrees of improvement in the T-lymphocyte subsets .
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