干扰素-β1b治疗复发缓解型多发性硬化16例疗效及经验总结

A review of clinical efficacy and experience of IFN-β1b in treating 16 “relapsing-remitting multiple sclerosis” patients

目的评价东北地区复发缓解型多发性硬化(RRMS)患者应用IFN-β1b的疗效及安全性。方法统计16例RRMS患者用药前后的ARR、平均EDSS评分以评价IFN-β1b的疗效,总结IFN-β1b相关的药物不良反应及其严重程度,评价药物的耐受性及安全性,并进一步分析停药原因。结果 (1)16例RRMS患者平均应用IFN-β1b 11.7 m,治疗前后的ARR分别为(1.65±1.01)、(0.97±1.00),t=2.307,P<0.05,差异有统计学意义;治疗前后的平均DESS评分分别为(2.63±1.04)、(2.03±1.58),t=2.164,P<0.05,差异有统计学意义;(2)16例患者累计不良反应发生21例次,分别为流感样副作用9例,注射部位红肿或硬结7例,肝功能异常3例,轻度血白细胞降低1例,脱发1例,其中1例患者因持续肝功异常而停用IFN-β1b;(3)16例患者中2例患者停用IFN-β1b,1例患者因药物不良反应停用,1例患者认为IFN-β1b"无效"停用。结论 (1)IFN-β1b可降低RRMS患者的ARR,改善EDSS评分,延缓疾病的进展;(2)IFN-β1b相关的不良反应以流感样症状和注射部位反应最为常见,部分患者出现肝功异常,多数症状轻微可自行缓解,少数严重不良反应可于减量后继续使用或停用。

Objective To evaluate the clinical efficacy and security of IFN-βlb in patients with RRMS in northeast. Methods Compare the annualized relapse rate （ARR）, expanded disability status scale （EDSS）score before and after the treatment of the sixteen RRMS patients to evaluate the clinical efficacy of IFN-β1b, summarize the side-effects and its sever- ity of IFN-β1b to evaluate the security of IFNq31 b, and analyze the reasons of discontinuation of the IFN-β1b. Results （ 1 ）The average time of using IFN-βlb of the sixteen patients is was 11.7 month,ARR before and after the treatment iswas （1.65 ± 1.O1）and（0.97 ± 1.00）,t =2. 307,P 〈0.05 ;EDSS score is（2.63 ± 1.04） and（2.03±1.58）,t =2. 164,P 〈 O. 05, the differences are were statistically significant. （2） There are were twenty-one cases about the side-effects of IFN- 131b, they are were flu-like symptoms （9/21）, injection site reactions （7/21）, abnormal live function（ 3/21 ）, slightly reduc- tion of WBC（ 1/21 ） and hair loss（ 1/21 ） ,one patient ceased to use IFN-β1b because of persistent abnormal live function. （3） Two patients ceased to use IFN-βlb in 16 patients, one patient ceased because of the persistent abnormal live function, one patient ceased because of the ＂useless＂ of IFN-β1b. Conclusion （ 1 ） The research indicates that IFN-βlb could re- duce the ARR and EDSS score of RRMS patients,delay the progression of clinical course. （2）Flu-like symptoms and injec- tion site reactions are the most common side-effects of IFN-β1b, abnormal live function is also not rare. The majority of side-effects could alleviate without interverse, the rarely severe side-effects could be tolerated by reduction or interrupting use for a while.