粒细胞集落刺激因子和促红细胞生成素单药或联合用药治疗多发性硬化的临床效果分析

An Evaluation of Individual and Combined Therapy Using Granulocyte-Colony Stimulating Factor and Erythropoietin in Multiple Sclerosis

目的探讨粒细胞集落刺激因子(G-csf)和促红细胞生成素(EPO)单药或联合用药治疗多发性硬化(MS)的临床效果。方法将60例MS患者分为G-csf组、EPO组、G-csf+EPO组(联合治疗组)及对照组(每组15例)。前3组在对照组甲基强的松龙治疗的基础上分别加入G-csf、EPO及G-csf联合EPO,在治疗期间(治疗前及治疗7、14、28 d)及随访期间(治疗后3、6、12、24个月)对患者的EDSS评分、磁共振T2WI及增强序列病灶数目进行评估。结果在降低EDSS评分及磁共振T2WI病灶数目方面,治疗期间各组组内降低程度均有统计学差异(P<0.01);各治疗组与对照组比较,差异有统计学意义(P<0.05),联合治疗组优于单药治疗组(P<0.05),各单药组间比较无统计学差异(P>0.05)。各组治疗期间磁共振增强序列病灶均减少,随访期间治疗组与对照组比较有统计学差异(P<0.05),各治疗组间比较无统计学差异(P>0.05)。结论G-csf及EPO单药或联合用药治疗MS安全有效,二者有联合效应。

Objective This study aimed to investigate the therapeutic efficacy of granulocyte-colony stimulating factor(G-csf)and EPO mono-and combination-therapy in patients with multiple sclerosis(MS).Methods Sixty patients with MS were divided into the following groups:G-csf,EPO,combination,and control(15 cases in each group).The former three groups received methylprednisolone and G-csf,EPO,and G-csf combined with EPO,respectively,and the control group was treated with methylprednisolone.Patients were assessed for their EDSS scores,the number of lesions in MRI T2WI,and enhanced sequences during treatment(before treatment and on days 7,14,28)and during the follow-up period(3,6,12,and 24 months after treatment).Results The degree of reduction in the EDSS scores and the number of MRI T2WI lesions in each group,was statistically different(P<0.01),and the combination group was superior to the two monotherapy groups(P<0.05),and there was no difference observed between the two monotherapy groups(P>0.05).Furthermore,MRI-enhanced lesions were decreased during the treatment period.During the follow-up period,a significant difference between the treatment and control groups was reported(P<0.05)with no significant difference observed between the treatment groups(P>0.05).Conclusion In patients with MS,mono-and combined therapy with G-csf and EPO are safe and effective,and a synergistic effect is demonstrated with combination therapy.