环孢素A与硫唑嘌呤治疗视神经脊髓炎谱系疾病的效果比较

Comparison on efficacy of cyclosporine A versus azathioprine in the treatment of neuromyelitis optica spectrum disorders

目的比较环孢素A与硫唑嘌呤治疗视神经脊髓炎谱系疾病(NMOSD)的效果。方法抽取2015年7月至2020年6月焦作市人民医院收治的NMOSD患者64例,按照随机数字表法分为环孢素A组(32例)和硫唑嘌呤组(32例)。硫唑嘌呤组采用硫唑嘌呤治疗,环孢素A组采用环孢素A治疗。比较两组疗效、视神经功能[扩展残疾状态量表(EDSS)评分]、日常生活能力(ADL)评分、不良反应发生率及复发率。结果环孢素A组总有效率(90.63%,29/32)与硫唑嘌呤组(75.00%,24/32)比较差异未见统计学意义(P>0.05)。治疗后6、12个月,两组EDSS评分均较治疗前降低,ADL评分均较治疗前增高(P均<0.05),但组间比较差异未见统计学意义(P>0.05)。环孢素A组血尿、脱发、牙龈肿胀、肝功能损伤发生率与硫唑嘌呤组比较差异未见统计学意义(P>0.05)。环孢素A组复发率(21.88%,7/32)与硫唑嘌呤组(28.13%,9/32)比较差异未见统计学意义(P>0.05)。结论环孢素A与硫唑嘌呤治疗NMOSD均有较好效果,可改善患者视神经功能及日常生活能力,减少复发,且具有用药安全性。

Objective To compare the effects of cyclosporine A and azathioprine in the treatment of neuromyelitis optica spectrum disorders(NMOSD).Methods Sixty-four patients with NMOSD treated in Jiaozuo People’s Hospital from July 2015 to June 2020 were selected,and they were divided into cyclosporine A group and azathioprine group by random number table method,with 32 cases in each group.Azathioprine group was treated with azathioprine,and cyclosporine A group was treated with cyclosporine A.The efficacy,expanded disability status scale(EDSS)score,activity of daily living scale(ADL)score,adverse reactions and recurrence rate were compared between the two groups.Results There was no significant difference in total effective rate between cyclosporine A group(90.63%,29/32)and azathioprine group(75.00%,24/32),P>0.05.After 6 and 12 months of treatment,EDSS score was lower,and ADL score was higher in both groups,compared with these indexes before treatment(P<0.05);but there was no significant difference in these indexes between the two groups after 6 and 12 months of treatment(P>0.05).There was no significant difference in the incidence of hematuria,hair loss,gingival swelling and liver function injury between cyclosporine A group and azathioprine group(P>0.05).There was no significant difference in recurrence rate between cyclosporine A group(21.88%,7/32)and azathioprine group(28.13%,9/32),P>0.05.Conclusions Both cyclosporine A and azathioprine have good effects in the treatment of NMOSD,which can improve optic nerve function and ability of daily living,and reduce recurrence,with high drug safety.