慢性炎症性脱髓鞘性多发性神经病治疗的研究进展

Research Progress of Treatment of Chronic Inflammatory Demyelinating Polyneuropathy

慢性炎症性脱髓鞘性多发性神经病是由免疫介导的周围神经病,其临床表现及病程多样,诊断及治疗困难。静脉注射免疫球蛋白、糖皮质激素及血浆置换在随机对照试验中被证明有效,在制订治疗方案时应结合医疗成本、药物疗效、不良反应等因素。如果对常规治疗无效或变得难治不能耐受时应该考虑其他治疗,如硫唑嘌呤、环孢素、环磷酰胺、干扰素、甲氨蝶呤、霉酚酸酯、利妥昔单抗、依那西普等药物。

Chronic inflammatory demyelinating polyneuropathy is an immune-mediated disease of the peripheral nervous system,which can be difficult to diagnose and treat due to the diversity of the clinical mani-festations and disease process. Intravenous immunoglobulin, corticosteroids and plasma exchange have all been proven to be beneficial in randomized controlled trials. Treatment solution should be made taking the cost,effect and adverse effects into account. When patients do not respond or become refractory or intolerant to these conventional treatments, other treatments such as azathioprine, ciclosporin A, cyclophosphamide, interferons, methotrexate, mycophenolate mofetil, rituximab and etanercept should be considered.