Harbo Thomas, Andersen Henning, Jakobsen Johannes
Department of Neurology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark.
Muscle Nerve. 2009 Apr;39(4):439-47. doi: 10.1002/mus.21305.
In chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), the acute motor response following withdrawal and reestablishment of intravenous immunoglobulin (IVIG) therapy was studied. In a prospectively designed case series 11 CIDP patients in IVIG maintenance therapy were assessed with isokinetic dynamometry, nerve conduction studies, and functional tests. After short-term withdrawal of IVIG, eight treatment-responsive patients had a 14.2% (8.6-20.0) loss of isokinetic strength of 12 muscle groups. Three patients remained stable without treatment and were excluded from further study. On days 5 and 10 after reinitiation of IVIG therapy isokinetic muscle strength increased by 5.5% (1.6-9.6) and 11.9% (7.5-16.5), respectively, but there was no further increase at day 15. Improvement of walking velocity and hand function coincided. The minimal F-wave latency shortened, whereas other electrophysiological parameters remained unchanged. In conclusion, isokinetic dynamometry is a sensitive and clinically relevant method for monitoring the acute response to IVIG treatment in CIDP.
在慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）中，研究了静脉注射免疫球蛋白（IVIG）治疗停药和重新用药后的急性运动反应。在一个前瞻性设计的病例系列中，对11例接受IVIG维持治疗的CIDP患者进行了等速肌力测试、神经传导研究和功能测试。短期停用IVIG后，8例治疗有反应的患者12个肌肉群的等速肌力丧失了14.2%（8.6 - 20.0）。3例患者未经治疗病情保持稳定，被排除在进一步研究之外。重新开始IVIG治疗后第5天和第10天，等速肌肉力量分别增加了5.5%（1.6 - 9.6）和11.9%（7.5 - 16.5），但在第15天没有进一步增加。步行速度和手部功能的改善是同步的。最小F波潜伏期缩短，而其他电生理参数保持不变。总之，等速肌力测试是监测CIDP患者对IVIG治疗急性反应的一种敏感且与临床相关的方法。
