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在接受β-干扰素治疗的复发缓解型多发性硬化症患者中,脑脊液寡克隆带缺失与残疾进展延迟相关。

Absence of cerebrospinal fluid oligoclonal bands is associated with delayed disability progression in relapsing-remitting MS patients treated with interferon-beta.

作者信息

Annunziata Pasquale, Giorgio Antonio, De Santi Lorenzo, Zipoli Valentina, Portaccio Emilio, Amato Maria Pia, Clerici Raffaella, Scarpini Elio, Moscato Gianluca, Iudice Alfonso, Vacca Giovanni, Orefice Giuseppe, Morra Vincenzo Brescia, Maimone Davide

机构信息

Department of Neurological Sciences and Behaviour, University of Siena, Italy.

出版信息

J Neurol Sci. 2006 May 15;244(1-2):97-102. doi: 10.1016/j.jns.2006.01.004. Epub 2006 Feb 13.

Abstract

To assess the role of CSF oligoclonal bands (OB) in determining the clinical outcome in patients with relapsing-remitting multiple sclerosis (RRMS) treated with IFN-beta, we carried out a retrospective, multicentre, observational study recruiting 209 RRMS patients from six MS centres from northern, central and southern areas of Italy under treatment with IFN-beta-1a i.m., IFN-beta-1a s.c. and IFN-beta-1b s.c. Twenty-two of 209 patients (10.6%) showed no OB in CSF. The patients without had, at disease onset, significantly higher frequency of visual disturbances (p=0.02) and less sensory involvement (p=0.04) than those with OB. A statistical trend (p=0.056) towards a longer time to reach sustained disability progression during treatment was found in patients without compared to those with OB. Thirty-six of 187 (19%) patients with OB worsened by at least 1 EDSS point compared to none of 22 (0%) OB-negative patients (p=0.017). The delaying of disability progression in OB-negative patients during treatment was significantly dependent only on the number of baseline MRI T2-weighted lesions (p=0.012) that was found to be significantly lower in OB-negative than in OB-positive patients (p=0.04). The absence of OB and low number of baseline T2-weighted lesions in this cohort of MS patients are favourable prognostic factors influencing the clinical response to IFN-beta treatment in RRMS patients.

摘要

为评估脑脊液寡克隆区带(OB)在确定复发缓解型多发性硬化症(RRMS)患者接受干扰素β治疗的临床结局中的作用,我们开展了一项回顾性、多中心、观察性研究,从意大利北部、中部和南部地区的六个MS中心招募了209例接受肌肉注射干扰素β-1a、皮下注射干扰素β-1a和皮下注射干扰素β-1b治疗的RRMS患者。209例患者中有22例(10.6%)脑脊液中未检测到OB。与有OB的患者相比,无OB的患者在疾病发作时视觉障碍的发生率显著更高(p = 0.02),感觉受累情况更少(p = 0.04)。与有OB的患者相比,未检测到OB的患者在治疗期间达到持续残疾进展的时间有统计学上的延长趋势(p = 0.056)。187例有OB的患者中有36例(19%)扩展残疾状态量表(EDSS)评分至少恶化1分,而22例OB阴性患者中无一例恶化(0%)(p = 0.017)。治疗期间OB阴性患者残疾进展的延迟仅显著取决于基线MRI T2加权病灶数量(p = 0.012),且发现OB阴性患者的基线MRI T2加权病灶数量显著低于OB阳性患者(p = 0.04)。在这组MS患者中,无OB和基线T2加权病灶数量少是影响RRMS患者对干扰素β治疗临床反应的有利预后因素。

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