甲泼尼龙琥珀酸钠冲击治疗对急性视神经炎患者视功能及血清AQP4-Ab、ANAs水平的影响

Effect of pulse therapy of methylprednisolone sodium succinate on visual function and serum levels of AQP4-Ab and ANAs in patients with acute optic neuritis

目的探讨甲泼尼龙琥珀酸钠冲击治疗对急性视神经炎患者视功能及血清水通道蛋白4抗体(AQP4-Ab)、抗核抗体(ANAs)的影响。方法我院收治的120例(188眼)急性视神经炎患者,按随机数表法分为观察组和对照组各60例(92眼、96眼),前者给予甲泼尼龙琥珀酸钠冲击和泼尼松治疗,后者给予地塞米松和泼尼松治疗。治疗结束后评估临床疗效,3个月复查视力情况,并于治疗前后空腹采血,检测自身免疫抗体AQP4-Ab、ANAs阳性率。结果两组近期疗效比较差异无统计学意义(P>0.05),但观察组总有效率高于对照组(P<0.05)。两组治疗结束后及治疗后3个月视力均高于治疗前,且观察组高于对照组(P<0.05)。两组治疗结束后AQP4-Ab、ANAs阳性率均低于治疗前,且观察组低于对照组(P<0.05)。结论甲泼尼龙琥珀酸钠冲击治疗急性视神经炎疗效可观,可提高患者视功能及降低自身免疫抗体阳性率。

Objective To investigate the effect of pulse therapy of methylprednisolone sodium succinate on the visual function and serum aquaporin 4 antibody（ AQP4 Ab） and antinuclear antibody（ ANAs） in patients with acute optic neuritis. Methods One hundred and twenty patients（ 188 eyes） with acute optic neuritis who were admitted to the ophthalmology department of our hospital were randomly divided into experimental group（ 60 cases and 92 eyes） and control group（ 60 cases,96 eyes）.The experimental group was treated with pulse therapy of methylprednisolone sodium succinate and prednisone while the control group was treated with dexamethasone and prednisone.After treatment,the clinical efficacy was evaluated. The visual acuity was reexamined 3 months later. Fasting blood samples were collected before and after treatment to detect the positive rates of AQP4-Ab and ANAs.Results There was no significant difference in the short-term curative effect between the two groups（ P〈0. 05）. However,the total effective rate in the experimental group was significantly higher than that in the control group（ P〈0. 05）.The visual acuity was increased after treatment and 3 months later（ P〈0. 05）.The increase in the experimental group was significantly greater than that in the control group（ P〈0. 05）.The positive rate of AQP4-Ab and ANAs after treatment was lower than before treatment in the two groups（ P〈0. 05）.The positive rate in the experimental group was significantly lower than that in the control group（ P〈0. 05）. Conclusion The pulse therapy of methylprednisolone sodium succinate is significantly effective in the treatment of acute optic neuritis.It can improve the visual function in patients and decrease the positive rates of autoantibodies.