文章摘要
柯莉,方登富,潘飞豹,等.米托蒽醌联合甲泼尼龙治疗复发缓解型多发性硬化的疗效及对血清学指标的影响[J].安徽医药,2020,24(3):603-606.
米托蒽醌联合甲泼尼龙治疗复发缓解型多发性硬化的疗效及对血清学指标的影响
Effect of mitoxantrone combined with methylprednisolone on relapsed and relieved multiple sclerosis and its influence on serological parameters
  
DOI:10.3969/j.issn.1009?6469.2020.03.046
中文关键词: 多发性硬化,复发缓解性  甲泼尼龙  金属蛋白酶 1组织抑制剂  米托蒽醌  基质金属蛋白酶 9 .0,
英文关键词: Multiple sclerosis,relapsing?remitting  Methylprednisolone  Tissue inhibitor of metalloproteinase?1  Mitoxan? trone  Matrix metalloproteinase 9
基金项目:
作者单位
柯莉 遂宁市中心医院神经内科四川遂宁 629000 
方登富 遂宁市中心医院神经内科四川遂宁 629000 
潘飞豹 遂宁市中心医院神经内科四川遂宁 629000 
赵磊 遂宁市中心医院神经内科四川遂宁 629000 
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中文摘要:
      目的研究米托蒽醌联合糖皮质激素治疗复发缓解型多发性硬化( MS)的疗效及对血清学指标的影响。方法选择 2016年 3月至 2018年 1月期间遂宁市中心医院收治的复发缓解型 MS(RRMS)病人 54例,采用随机数字表法分为接受米托蒽醌联合糖皮质激素治疗的观察组、接受糖皮质激素治疗的对照组,各 27例。对照组给予甲泼尼龙起始剂量 1 000 mg/d静滴,每 3天减半量, 12 d后改为甲泼尼龙 60毫克 /次、口服、 1次/天,服用 1周后逐步减量、每 5~7天减量 8 mg,减为 4 mg/d后维持;观察组病人给予米托蒽醌联合糖皮质激素治疗,糖皮质激素甲泼尼龙给药方法同对照组,同时给予米托蒽醌 12 mg/m2加入 500 mL 0.9%氯化钠溶液注射液、静滴,每 3个月 1次。治疗前及治疗后 6个月,采用神经功能状况评分( EDSS)评价神经功能,采用头颅 MRI判断病灶数目,采用试剂盒测定血清基质金属蛋白酶 9(MMP9)、组织金属蛋白酶抑制剂 1(TIMP1)的含量。结果治疗后 6个月,两组的 EDSS评分、 MRI增强病灶数目、血清 MMP9含量均明显降低,血清 TIMP1含量明显升高,均差异有统计学意义( P<0.05),且观察组病人的 EDSS评分、头颅 MRI病灶数目及血清 MMP9含量均明显低于对照组[(3.25±0.52)分比( 4.18±
英文摘要:
      Objective To study the efficacy of mitoxantrone combined with glucocorticoid on relapsing?remitting multiple sclerosis(MS)and its influence on serological parameters.Methods Fifty?four patients with relapsing?remitting MS(RRMS)in SuiningCentral Hospital during March 2016 to January 2018 were randomly divided into observation group treated with mitoxantrone com?bined with glucocorticoid and control group treated with glucocorticoid,with 27 cases in each group.The control group was given an intravenous infusion of methylprednisolone at a dose of 1 000 mg/d,which was halved every 3 days.After 12 days,it was changed to oral methylprednisolone 60 mg/time/day,and gradually reduced the dose after 1 week.The dose was decreased by 8 mg every 5?7 days,and maintained after reducing to 4 mg/d.Patients in the observation group were given mitoxantrone combined with glucocorti?coids as follows:Glucocorticoids were administered in the same way as the control group,and mitosterone was given at the same time.Anthraquinone 12 mg/m2 was added to 500 mL physiological saline injection,intravenously,once every 3 months.Before thera? py and 6 months after therapy,the neurological function was evaluated by the neurological status score(EDSS),the number of le? sions was evaluated by MRI,the levels of serum matrix metalloproteinase 9(MMP 9)and tissue inhibitor of metalloproteinase 1(TIMP 1)were determined by kits.Results After 6 months of therapy,the EDSS score,the number of lesions on MRI and the con? tent of MMP9 in serum of two groups were significantly lower than those before therapy,the content of TIMP1in serum was signifi? cantly higher than that before therapy(P<0.05),and the EDSS score(score of the control group and observation group after treat? ment:4.18±0.68,3.25±0.52),the number of lesions on MRI(number of lesions in the control group and observation group after treatment:3.29±0.57,2.36±0.41)and the content of MMP9[contents of the control group and observation group after treatment:(23.31±3.89)ng/mL,(18.95±2.52)ng/mL]in serum of observation group were significantly lower than those in the control group, and the content of TIMP1[control group and observation group content after treatment:(5.27±0.79)ng/mL,(5.89±0.78)ng/mL] in serum was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions,including leukocyte reduction,liver dysfunction,nausea and vomiting,infection between two groups was not statistically different(P>0.05).Conclu? sion Mitoxantrone combined with Methylprednisolone can improve the neurological function,reduce the number of lesions,regu? late MMP9/TIMP1 and has better safety.
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