Wiles C M, Brown P, Chapel H, Guerrini R, Hughes R A C, Martin T D, McCrone P, Newsom-Davis J, Palace J, Rees J H, Rose M R, Scolding N, Webster A D B
Sobell Department of Neurophysiology, Institute of Neurology, Queen Square, London WCIN 3BG, UK.
J Neurol Neurosurg Psychiatry. 2002 Apr;72(4):440-8. doi: 10.1136/jnnp.72.4.440.
Treatment of neurological disorders with intravenous immunoglobulin (IVIg) is an increasing feature of our practice for an expanding range of indications. For some there is evidence of benefit from randomised controlled trials, whereas for others evidence is anecdotal. The relative rarity of some of the disorders means that good randomised control trials will be difficult to deliver. Meanwhile, the treatment is costly and pressure to "do something" in often distressing disorders considerable. This review follows a 1 day meeting of the authors in November 2000 and examines current evidence for the use of IVIg in neurological conditions and comments on mechanisms of action, delivery, safety and tolerability, and health economic issues. Evidence of efficacy has been classified into levels for healthcare interventions (tables 1 and 2).
静脉注射免疫球蛋白（IVIg）治疗神经系统疾病在我们的临床实践中越来越常见，适应证范围不断扩大。对于某些疾病，有随机对照试验证明其有益，而对于其他疾病，证据则是 anecdotal（此处疑有误，可能是“ anecdotal”，意为“传闻的、轶事性的” ）。某些疾病相对罕见，这意味着难以开展高质量的随机对照试验。同时，这种治疗成本高昂，而且在常常令人痛苦的疾病中，“采取措施”的压力很大。本综述基于作者于2000年11月召开的为期1天的会议，审视了目前IVIg用于神经系统疾病的证据，并对作用机制、给药方式、安全性和耐受性以及卫生经济学问题进行了评论。疗效证据已按照医疗保健干预措施的级别进行分类（表1和表2）。
