山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
31期
18-20
,共3页
董艳玲%李吕力%李瑶宣%梁浩%滕晓茗
董豔玲%李呂力%李瑤宣%樑浩%滕曉茗
동염령%리려력%리요선%량호%등효명
多发性硬化%甲基强的松龙%鞘内注射%T淋巴细胞
多髮性硬化%甲基彊的鬆龍%鞘內註射%T淋巴細胞
다발성경화%갑기강적송룡%초내주사%T림파세포
multiple sclerosis%methylprednisolone%intrathecal injection%T-lymphocyte subsets
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。
目的:觀察鞘內註射甲基彊的鬆龍( MPS)治療急性期多髮性硬化( MS)的效果及其對患者T淋巴細胞亞群的影響。方法將80例急性期MS患者隨機分為鞘內註射組35例、遲擊組45例,兩組均常規應用營養神經藥物,併分彆予MPS鞘內註射及常規靜脈註射遲擊治療。兩組均于治療前和治療後2週採用流式細胞儀檢測外週血和T淋巴細胞亞群水平,採用Kurtzke擴展緻殘量錶(EDSS)進行神經功能評分(計算治療前後評分差值ΔEDSS評分)。結果治療後5 d時鞘內註射組ΔEDSS評分顯著高于遲擊組,P<0.05(t=17.516);治療後10、15 d兩組ΔEDSS評分比較,P均﹥0.05。與治療前比較,兩組治療後腦脊液中CD4+細胞減少、CD8+細胞增多,外週血中CD8+細胞增多、CD4+/CD8+降低;兩組治療後T淋巴細胞亞群各指標比較均無顯著差異(P均﹥0.05)。結論鞘內註射MPS可顯著改善MS患者神經功能及調節T淋巴細胞亞群平衡,且起效較快。
목적:관찰초내주사갑기강적송룡( MPS)치료급성기다발성경화( MS)적효과급기대환자T림파세포아군적영향。방법장80례급성기MS환자수궤분위초내주사조35례、충격조45례,량조균상규응용영양신경약물,병분별여MPS초내주사급상규정맥주사충격치료。량조균우치료전화치료후2주채용류식세포의검측외주혈화T림파세포아군수평,채용Kurtzke확전치잔량표(EDSS)진행신경공능평분(계산치료전후평분차치ΔEDSS평분)。결과치료후5 d시초내주사조ΔEDSS평분현저고우충격조,P<0.05(t=17.516);치료후10、15 d량조ΔEDSS평분비교,P균﹥0.05。여치료전비교,량조치료후뇌척액중CD4+세포감소、CD8+세포증다,외주혈중CD8+세포증다、CD4+/CD8+강저;량조치료후T림파세포아군각지표비교균무현저차이(P균﹥0.05)。결론초내주사MPS가현저개선MS환자신경공능급조절T림파세포아군평형,차기효교쾌。
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 .