Department of Neurology, Tampere University Hospital and Neuroimmunology Unit, Medical School, University of Tampere, Tampere, Finland.
Acta Neurol Scand. 2010 Nov;122(5):309-15. doi: 10.1111/j.1600-0404.2009.01317.x.
The use of high-dose polyclonal intravenous immunoglobulin (IVIG) in the treatment of autoimmune neurological diseases has expanded over the last decade. Based on controlled clinical trials IVIG can be considered currently as the first-line treatment in Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy, and it may be used as a rescue therapy in worsening myasthenia gravis. IVIG is a second-line therapy in dermatomyositis, stiff-person syndrome and pregnancy-associated or postpartum relapses of multiple sclerosis. Although the biological efficacy of IVIG is due to multiple effects on the immune system, many mechanisms are still unknown. The awareness of risks and complications of IVIG therapy has increased, but severe side effects are still considered rare. Due to increasing costs of this treatment, careful selection of patients who will benefit from IVIG is extremely important.
过去十年间，大剂量静脉注射免疫球蛋白（IVIG）在治疗自身免疫性神经疾病中的应用不断扩展。基于对照临床试验，IVIG 目前可被视为吉兰-巴雷综合征、慢性炎性脱髓鞘性多发性神经病和多发性运动神经病的一线治疗药物，并且它可能被用作重症肌无力恶化时的抢救疗法。IVIG 是皮肌炎、僵人综合征和妊娠或产后多发性硬化复发的二线治疗药物。尽管 IVIG 的生物学疗效归因于对免疫系统的多种作用，但许多机制仍不清楚。人们对 IVIG 治疗的风险和并发症的认识有所提高，但严重的副作用仍被认为较为罕见。由于这种治疗方法的费用不断增加，因此仔细选择将从 IVIG 中获益的患者极其重要。
