Saida K, Zhigang Z, Ozawa K, Konishi T, Saida T
Department of Neurology, Nishinara National Hospital, Nara.
Intern Med. 1999 Aug;38(8):636-42. doi: 10.2169/internalmedicine.38.636.
Mizoribine (MZR), imidazole nucleotide, inhibits purine synthesis and helper T cell functions. It is used as an immunosuppressant in chronic rheumatic arthritis in Japan. Twenty-four patients with relapsing-remitting and chronic progressive multiple sclerosis (MS) were studied for the long-term effects of MZR over 8 years.
Average daily MZR doses of 200 mg along with prednisolone (PSL) were administered in the patients studied. Ten of 24 patients were treated for more than 5 years.
The mean relapse rate per year at entry (1.50 +/- 0.24, mean +/- SE, n = 22) decreased [0.46 +/- 0.24 (n = 19)] after two years. In 70% of the patients, the disability did not worsen. Eleven of 18 patients showed a mild decrease of the total lesion size in magnetic resonance imaging (MRI).
MZR was well tolerated and could be used for long-term in MS as an adjunctive immunosuppressant to PSL, and the PSL doses could be decreased. A further randomized controlled trial with PSL is necessary.
咪唑立宾（MZR），一种咪唑核苷酸，可抑制嘌呤合成及辅助性T细胞功能。在日本，它被用作慢性风湿性关节炎的免疫抑制剂。对24例复发缓解型和慢性进展型多发性硬化症（MS）患者进行了长达8年的咪唑立宾长期疗效研究。
对研究中的患者给予平均每日200毫克的咪唑立宾及泼尼松龙（PSL）。24例患者中有10例接受治疗超过5年。
入组时每年的平均复发率（1.50 +/- 0.24，平均值 +/- 标准误，n = 22）在两年后有所下降[0.46 +/- 0.24（n = 19）]。70%的患者残疾状况未恶化。18例患者中有11例在磁共振成像（MRI）中显示总病灶大小略有减小。
咪唑立宾耐受性良好，可作为泼尼松龙的辅助免疫抑制剂长期用于MS患者，且可降低泼尼松龙的剂量。有必要进一步开展与泼尼松龙相关的随机对照试验。
