复发缓解型多发性硬化症患者急性期甲泼尼龙结合缓解期 IFN_β治疗的疗效观察

摘要

Objective To observe curative effect of treatment of methylprednisolone in acute phase combined with IFN_βin remission period on relapsing remitting multiple sclerosis.Methods 84 patients with Relapsing Remitting Multiple Sclerosis (RRMS ) were di-vided into observation group and control group randomly ,each group had 42 patients.Observation group was treated with methylpred-nisolone pulse therapy (MPPT) in the acute phase ,and with IFN beta_1b treatment in remission phase.Patients in control group were treated with MPPT in acute phase ,with injection of sodium chloride solution in remission period.The curative effect of two groups in acute stage ,recurrencing rates of different stages ,Kurtzke Expanded Disability Status Scale (EDSS ) ,nuclear magnetic resonance (MRI) number ,volume of brain lesions ,and adverse reaction of IFNβ_1b were observed.Results Among 84 cases in the acute phase with MPPT treatment ,the total effective rate was 87.62% ;total recurrence rate of two years of the observation group (31.71% ) was lower than that of the control group (71.43% ) ,the difference was statistically significant ( P<0.01).The second_year recurrence rate of the observation group was lower than control group ,the difference was statistically significant ( P<0.05 ).The second_year recurrence rate of the test group is lower than the first year ,the difference was statistically significant ( P<0.05).At the end of sec-ond year ,subtractting the initial EDSS value ,the observation group was lower than that of the control group ,the difference was statis-tically significant ( P<0.01).0~12 and 0~24 months ,number and volume of brain lesions of MRI in observation group were lower than control group ,the difference was statistically significant ( P<0.05). Conclusions For RRMS patients ,the treatment of the MPPT in acute phase combined with IFN_βin remission period may have a better effect.%目的：观察急性期甲泼尼龙结合缓解期IFN_β治疗复发缓解型多发性硬化症（RRMS ）的疗效。方法84例RRMS患者，随机分为观察组及对照组，每组各42例。观察组在急性期采用甲泼尼龙冲击疗法（MPPT ）治疗，缓解期采用IFNβ_1b治疗；对照组在急性期采用MPPT治疗，缓解期注射0.9％氯化钠溶液。观察两组急性期疗效、不同时期的复发率、Kurtzke扩展残疾状况量表（EDSS ）评分、磁共振（MRI ）脑部病灶数量和体积及IFNβ_1b的不良反应。结果急性期MPPT治疗的84例患者，总有效率达97.62％。观察组两年总复发率（31.71％）低于对照组（71.43％），差异有统计学意义（ P＜0.01）；观察组第2年复发率低于对照组，差异有统计学意义（ P＜0.01）；且观察组第2年复发率低于第1年，差异有统计学意义（ P＜0.05）。第2年末－初始EDSS评分，观察组明显低于对照组，差异有统计学意义（ P＜0.01）。0～12个月和0～24个月，观察组MRI头部病灶数量和体积均明显低于对照组，差异有统计学意义（ P＜0.05）。结论对于RRMS患者，采用急性期MPPT结合缓解期IFN_β治疗可取得较好的疗效。