鼠神经生长因子联合糖皮质激素治疗视神经炎的疗效观察

Clinical observation of mouse nerve growth factor and glucocorticoid for patients with optic neuritis

目的观察鼠神经生长因子联合糖皮质激素治疗视神经炎的临床疗效。方法收集临床确诊为视神经炎的48例患者48只眼。其中,视神经乳头炎8例8只眼,球后视神经炎40例40只眼。将患者随机分为治疗组和对照组。治疗组:22例22只眼,给予肌注鼠神经生长因子30μg/次,1次/d,14天为1个疗程;全身静脉滴注地塞米松15mg/d,1周后改为强的松龙60mg/d口服,每7天减量,每次减量10mg,同时肌注维生素B1 100mg/d,维生素B120.5mg/d,连续14天,使用能量合剂、地巴唑10mg口服。对照组:26例26眼,除不使用鼠神经生长因子外,其余治疗同治疗组,对比分析两组患者治疗后的疗效。结果治疗组22只眼中,显效18只眼,占81.8%;有效2只眼,占9.1%;无效2只眼,占9.1%,总有效率为90.9%;对照组26只眼中,显效14只眼,占53.8%;有效8只眼,占30.8%;无效4只眼,占15.4%;总有效率为84.6%。两组总有效率比较,差异无统计学意义(χ2=0.432,P=0.511>0.05);显效率比较,差异有统计学意义(χ2=4.196,P=0.041<0.05)。结论糖皮质激素能有效治疗视神经炎,联合鼠神经生长因子治疗有更好疗效。

Objective To observe the efficacy of glucocorticoid and mouse nerve growth factor in treatment of optic neuritis.Methods 48patients（48eyes）with optic neuritis were enrolled in this study.There were 8patients（8eyes）with optic nerve papillitis and 40patients（40eyes）with retrobulbar neuritis.The patients were divided into treatment and control group：22patients（22eyes）in the treatment group,and 26patients（26eyes）in the control group.The treatment group received intramuscular injection of 30μg mouse nerve growth factor per day,14 times for one course,systemic intravenous injection of 15 dexamethasone mg per day for one week,and then prednisolone 60 mg per day orally.The dosage was reduced every 7days for 10 mg,intramuscular injection of vitamin B1（100mg）and vitamin B12（0.5mg）one time per day.Control group underwent the same therapy as the treatment group without mouse nerve growth factor.The efficacy differences between two groups were comparatively analyzed.Results Among 22 eyes in the treatment group,18eyes（81.8%）were markedly effective,two eyes（9.1%）were valid and two eyes（9.1%）were invalid.The total effective rate was 90.9%.Among 26 eyes in the control group,14eyes（53.8%）were markedly effective,8eyes（30.8%）were valid and four eyes（15.4%）were invalid.The total effective rate was 84.6 %.The difference of total effective rate between two groups was not statistically significant（χ2=0.432,P=0.511〉0.05）.There was a difference in markedly effective rate between two groups（χ2=4.196,P=0.041〈0.05）.Conclusion Mouse nerve growth factor combined with glucocorticoids is effective in treatment of optic neuritis.