低剂量利妥昔单抗治疗视神经脊髓炎谱系疾病的疗效

Efficacy of Low-Dose Rituximab in the Treatment of Neuromyelitis Optica Spectrum Disease

目的探索本文研究病例采取低剂量的利妥昔单抗达到的效果。方法选择我院2019年11月—2023年12月接收的30例视神经脊髓炎谱系疾病患者为研究对象,将其按照随机数字表法分组,分为观察组(n=15,低剂量利妥昔单抗)与对照组(n=15,吗替麦考酚酯)。对比两组治疗后扩展残疾状态量表(EDSS)评分,血清B淋巴细胞活化因子(BAFF)水平,血清AQP4-IgG水平、年复发率(ARR)、不良反应发生率以及生活质量(SF-36)评分。结果治疗后,观察组的EDSS评分低于对照组(P<0.05);治疗后,观察组BAFF水平以及血清AQP4-IgG水平均低于对照组(均P<0.05);治疗后,观察组的ARR低于对照组(P<0.05);观察组不良反应发生率为6.67%,低于对照组的26.67%(P<0.05);治疗后,观察组社会领域、生理领域、心理领域、环境领域评分均相较于对照组更高(均P<0.05)。结论使用低剂量利妥昔单抗治疗视神经脊髓炎谱系疾病治疗疗效较佳,能够有效改善神经功能,降低血清BAFF水平和AQP4-IgG水平,预防病情复发,安全性较高。

Objective To explore the effect of low-dose rituximab in the case studied in this paper.Methods Thirty patients with optic neuromyelitis optica spectrum disorders admitted to our hospital from November 2019 to December 2023 were selected for the study,and they were grouped according to the randomized numerical table method and divided into the observation group(n=15,low-dose rituximab)and the control group(n=15,merti-malcolmophenol ester).The Extended Disability Status Scale(EDSS)score,serum B-lymphocyte activating factor(BAFF)level,serum AQP4-IgG level,annual recurrence rate(ARR),incidence of adverse reactions,and quality of life(SF-36)score were compared between the two groups after treatment.Results After treatment,the EDSS score of the observation group was lower than that of the control group(P<0.05);after treatment,the BAFF level as well as the serum AQP4-IgG level of the observation group were lower than that of the control group(both P<0.05);after treatment,the ARR of the observation group was lower than that of the control group(P<0.05);the incidence rate of adverse reactions in the observation group was 6.67%,which was lower than that of the control group of 26.67%(P<0.05);after treatment,the observation group had higher scores in the social domain,physical domain,psychological domain,and environmental domain compared with the control group(all P<0.05).Conclusions The use of low-dose rituximab in the treatment of optic neuromyelitis optica spectrum disorders has better therapeutic efficacy,effectively improves neurological function,reduces serum BAFF levels and AQP4-IgG levels,and prevents recurrence of the disease,with a high degree of safety.