Tumiati B, Veneziani M, Castellini G, Belelli A
II Divisione Medica, Arcispedale S. Maria Nuova, Reggio Emilia.
Medicina (Firenze). 1990 Oct-Dec;10(4):398-401.
High intravenous doses (400 mg/kg) of gammaglobulin (IVIG) were administered monthly for six months to 7 patients with severe rheumatoid arthritis (RA). In all cases, previous treatment with NSAIDs and corticosteroids and in 3 of them with gold and/or methotrexate had been ineffective. A 50 per cent improvement of Ritchie index was obtained in 6/7 patients, morning stiffness was reduced from greater than 2 hours to less than 30 minutes in 6/7 patients. Swollen joints and Lee index improved in all patients. ESR did not show any change but RCP improved in 6/7 patients. The study of lymphocyte subpopulation showed no substantial changes in CD20+, CD3+, CD4 and CD8 cells as well as in CD4/CD8 ratio and a significant increase in 2H4+T cells without changes in 4B4+ subpopulation. IVIG improved the clinical and laboratory features of patients with severe RA. The major problem raised by IVIG therapy is its high cost suggesting that this therapy should only be applied in well selected patients with RA.
对7例重症类风湿性关节炎（RA）患者每月静脉注射高剂量（400毫克/千克）丙种球蛋白（IVIG），持续6个月。所有患者此前使用非甾体抗炎药（NSAIDs）和皮质类固醇治疗均无效，其中3例使用金制剂和/或甲氨蝶呤治疗也无效。7例患者中有6例的里奇指数改善了50%，7例患者中有6例的晨僵时间从超过2小时缩短至不到30分钟。所有患者的肿胀关节和李氏指数均有所改善。血沉（ESR）无变化，但7例患者中有6例的类风湿因子凝聚物（RCP）有所改善。淋巴细胞亚群研究显示，CD20 +、CD3 +、CD4和CD8细胞以及CD4/CD8比值无显著变化，2H4 + T细胞显著增加，4B4 +亚群无变化。IVIG改善了重症RA患者的临床和实验室特征。IVIG治疗引发的主要问题是成本高昂，这表明该疗法仅应适用于精心挑选的RA患者。
