静脉注射免疫球蛋白治疗慢性炎症性脱髓鞘性多发性神经根神经病：一项系统评价。

Intravenous immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review.

作者信息

van Schaik Ivo N, Winer John B, de Haan Rob, Vermeulen Marinus

机构信息

Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.

出版信息

Lancet Neurol. 2002 Dec;1(8):491-8. doi: 10.1016/s1474-4422(02)00222-3.

DOI:10.1016/s1474-4422(02)00222-3

PMID:12849334

Abstract

This review discusses the efficacy and safety in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) of intravenous immunoglobulin and compares this treatment with plasma exchange and prednisolone. We searched publications from 1985 onwards for randomised controlled studies examining the effects of intravenous immunoglobulin in patients with this immune-mediated neuromuscular disorder. Six trials, with 170 patients in total, were judged eligible. A significantly higher proportion of patients improved in disability within a month after the start of treatment with intravenous immunoglobulin than with placebo (relative risk 3.17 [95% CI 1.74 to 5.75]). During this period, intravenous immunoglobulin has similar efficacy to plasma exchange and oral prednisolone; therefore which of these treatments should be the first choice is currently uncertain. An algorithm on treatment approaches for CIDP is proposed.

摘要

本综述讨论了静脉注射免疫球蛋白治疗慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）的疗效和安全性，并将该治疗方法与血浆置换和泼尼松龙进行了比较。我们检索了1985年以来的出版物，以查找关于静脉注射免疫球蛋白对这种免疫介导的神经肌肉疾病患者影响的随机对照研究。共有六项试验符合要求，涉及170名患者。与安慰剂相比，静脉注射免疫球蛋白治疗开始后一个月内残疾状况改善的患者比例显著更高（相对风险3.17[95%可信区间1.74至5.75]）。在此期间，静脉注射免疫球蛋白的疗效与血浆置换和口服泼尼松龙相似；因此，目前尚不确定这些治疗方法中哪种应作为首选。本文提出了一种CIDP治疗方法的算法。