Ohji Satoru, Nomura Kyoichi
Department of Neurology, Saitama Medical Center, Saitama Medical University.
Nihon Rinsho. 2008 Jun;66(6):1127-32.
We discuss steroid pulse therapy and apheresis therapy indicated for the treatment of multiple sclerosis (MS). In the basic treatment course for MS, steroid pulse therapy is a first-line treatment for relapsing-remitting multiple sclerosis (RR-MS) in the course of the exacerbation, and apheresis therapy is performed in refractory cases. Treatment strategies for chronic progressive MS are not to be established. Steroid pulse therapy has been established as a treatment for MS in the active phase through randomized controlled trials (RCT). Apheresis therapy includes plasmapheresis and cytapheresis, and plasmapheresis includes plasma exchange (PE) and immunoadsorption plasmapheresis (IAPP). PE and IAPP are performed for MS treatment. PE has been established as a useful treatment for active phase MS. The efficacy of IAPP has been frequently reported, but no reports have been based on RCT. We also summarize the indications, methods, and adverse reactions of steroid pulse therapy and apheresis therapy.
我们讨论了用于治疗多发性硬化症（MS）的类固醇脉冲疗法和血液分离疗法。在MS的基础治疗过程中，类固醇脉冲疗法是复发缓解型多发性硬化症（RR-MS）病情加重时的一线治疗方法，而血液分离疗法则用于难治性病例。慢性进展型MS的治疗策略尚未确立。通过随机对照试验（RCT），类固醇脉冲疗法已被确立为MS活动期的一种治疗方法。血液分离疗法包括血浆置换和细胞分离，血浆置换包括血浆交换（PE）和免疫吸附血浆置换（IAPP）。PE和IAPP用于MS治疗。PE已被确立为MS活动期的一种有效治疗方法。IAPP的疗效已有很多报道，但尚无基于RCT的报告。我们还总结了类固醇脉冲疗法和血液分离疗法的适应证、方法及不良反应。
