Gasca-Salas Carmen, Gómez-Ibáñez Asier
Departamento de Neurología, Clinica Universitaria de Navarra, 31008 Pamplona, Espana.
Rev Neurol. 2011 Nov 1;53(9):555-60.
The aetiology of multiple sclerosis remains unknown at the present time, although the most likely explanation is that it has an autoimmune inflammatory origin. During the history of this disease a vascular pathophysiology was once proposed, and it has recently re-emerged as a result of the work by Paolo Zamboni with the name of 'chronic cerebrospinal venous insufficiency'. Following this hypothesis, Zamboni puts forward a curative treatment for multiple sclerosis by means of endovascular treatment of the internal jugular vein and the azygos vein. However, several teams have attempted to replicate his findings without success. In this review, we offer a chronological description of the studies carried out by Zamboni and the later attempts to replicate his work. Our main conclusion is that, given the results we currently have available, we should be cautious and, for the time being, it would be advisable not to recommend the systematic use of this treatment for our patients.
目前,多发性硬化症的病因仍不明确,不过最有可能的解释是它源于自身免疫性炎症。在这种疾病的历史上,曾有人提出过血管病理生理学,最近由于保罗·赞博尼的研究工作,它以“慢性脑脊髓静脉功能不全”的名称再次出现。根据这一假说,赞博尼提出了一种通过颈内静脉和奇静脉的血管内治疗来治愈多发性硬化症的方法。然而,几个研究团队试图重复他的研究结果,但均未成功。在这篇综述中,我们按时间顺序描述了赞博尼所进行的研究以及后来试图重复其工作的情况。我们的主要结论是,鉴于我们目前所掌握的结果,我们应该谨慎行事,目前,不建议对我们的患者系统性地使用这种治疗方法。