环磷酰胺治疗多发性硬化远期疗效观察

Remote Efficacy of Cyclophosphamide in Treatment of Multiple Sclerosis

目的 评价环磷酰胺 ( CTX)治疗多发性硬化 ( MS)的远期疗效及安全性。 方法 对 49例 MS患者分成 CTX治疗组与非 CTX治疗组进行回顾性研究 ,观察两组病人复发率情况 ,kurtzke评分 ( EDSS)的动态变化、核磁共振显像 ( MRI)的变化 ,以及 CTX的副反应。 结果 ( 1) CTX治疗组的复发率低于非 CTX治疗组 ( P<0 .0 5 )。 ( 2 )半年以后 CTX治疗组 kurtzke评分较非 CTX治疗组低 ( P<0 .0 5 )。 ( 3 )半年后 CTX治疗组MRI检查显示活动性病灶的检出率也低于非 CTX治疗组 ( P<0 .0 5 )。 ( 4 ) CTX治疗的主要副反应有白细胞减少、恶心、呕吐。结论 CTX治疗能减少 MS复发率 ,延缓 MS的进展。

OBJECTIVE To evaluate remote efficacy and safety of cyclophosphamide in treatment of multiple sclerosis(MS).METHODS in this retrospective study,49 patients with MS were divided into cyclophosphamide group and no cyclophosphamide group.The change on the expanded disability status scale(EDSS),relapse rate,magnetic resonance imaging(MRI),and the side reaction of cyclophosphamide in the two groups were observed.RESULTS (1)The relapse rate was significantly lower in cyclophosphamide group than in placebo(P<0 05).(2)Scores of EDSS were lower in the cyclophosphamide group after six months.(P<0 05).(3)The detection of active lesion on MRI was lower in the cyclophosphamide group(P<0 05).(4)The major side effects were granulocytopenia.nausea and vomiting.CONCLUSION cyclophosphamide can decrease relapse rate and delay progression in disability.Serious side reactions were rare.