甲泼尼龙联合米托蒽醌治疗复发缓解型多发性硬化的效果

Clinical Effect of Methylprednisolone Combined with Mitoxantrone in the Treatment of Relapsing-Remitting Multiple Sclerosis

目的探究甲泼尼龙(MPS)联合米托蒽醌(MTX)治疗复发缓解型多发性硬化(RRMS)的效果。方法选取河南省直第三人民医院2018年1月至2020年7月收治的78例RRMS患者为研究对象,按照随机数表法分为研究组(39例)和常规组(39例)。常规组接受MPS治疗,研究组接受MPS联合MTX治疗。比较两组疗效,扩展残疾状态量表(EDSS)评分、病灶数目、组织金属蛋白酶抑制剂1(TIMP-1)、血清基质金属蛋白酶9(MMP-9)水平及不良反应发生率。结果研究组总有效率高于常规组(92.31%比74.36%,P<0.05)。治疗3个月研究组EDSS评分低于常规组(P<0.05),病灶数目少于常规组(P<0.05),血清MMP-9水平低于常规组(P<0.05),血清TIMP-1水平高于常规组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论MPS联合MTX治疗RRMS效果较好,可通过调节血清MMP-9、TIMP-1水平改善神经功能,减少病灶数目,不良反应未增加。

Objective To explore the clinical efficacy of methylprednisolone combined with mitoxantrone in the treatment of relapsing-remitting multiple sclerosis(RRMS).Methods A total of 78 patients with RRMS who were admitted to the Third People’s Hospital of Henan Province from January 2018 to July 2020 were selected as the research subjects,and were divided into study group(39 cases)and routine group(39 cases)according to the random number table method.Routine group received methylprednisolone treatment,and study group received methylprednisolone combined with mitoxantrone treatment.Compare the efficacy of the two groups,the Kurtzke expanded disability status scale(EDSS),number of lesions,tissue inhibitor of metalloproteinase 1(TIMP-1)level,matrix metalloproteinase 9(MMP-9)level and adverse reactions.Results The total effective rate of study group was higher than that of the routine group(92.31%vs.74.36%,P<0.05).After 3 months of treatment,compared with routine group,the study group had lower EDSS score(P<0.05),fewer lesions(P<0.05),lower level of MMP-9(P<0.05),and higher level of TIMP-1(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion MPS combined with MTX is effective in the treatment of RRMS.It could improve nerve function by adjusting serum MMP-9 and TIMP-1 levels,reduce the number of lesions,and have fewer complications.