Khamidulla A, Kabdrakhmanova G, Utepkaliyeva A, Darin D, Urasheva Zh
West Kazakhstan Marat Ospanov State Medical University, Actobe, Kazakhstan.
Georgian Med News. 2018 May(278):93-83.
Multiple sclerosis is a chronic dysimmune neurodegenerative disease of the central nervous system, that affects people of working age and inevitably leads to disability. Treatment of the disease is one of the urgent problems of modern clinical neurology, which is explained by the variety of clinical variants of the flow, the lack of an effective method of treatment. This article is devoted to a review of modern approaches to the issues of etiology, pathogenesis and treatment of multiple sclerosis. Also, the classification of multiple sclerosis depending on the course of the disease, data on modern approaches to the treatment of multiple sclerosis, the criteria for the appointment of differentiated therapy depending on the course of the disease with the use of Disease-Modifying Drugs (DMDs) are given. The main strategies for the use of DMDs are described: escalation and de-escalation. The authors of the article presented a clinical case of observation and treatment of a patient with a remitting-relapsing type of multiple sclerosis with a rapid transformation to the secondary-progressive course. The analysis of the dynamics of clinical manifestations with the reflection of the degree of progression on the EDSS scale, analysis of the the radiological study data, as well as the analysis of the prescription of the drugs of the first-line and the second-line treatment to this patient during the observation period from 2010 to 2017 are given.
多发性硬化症是一种中枢神经系统的慢性免疫功能紊乱性神经退行性疾病，影响处于工作年龄的人群，并不可避免地导致残疾。该疾病的治疗是现代临床神经病学的紧迫问题之一，这是由疾病病程的多种临床变体以及缺乏有效的治疗方法所导致的。本文致力于综述多发性硬化症的病因、发病机制和治疗问题的现代方法。此外，还给出了根据疾病病程对多发性硬化症的分类、关于多发性硬化症现代治疗方法的数据、使用疾病修正药物（DMDs）根据疾病病程进行差异化治疗的用药标准。描述了使用DMDs的主要策略：升级和降级。本文作者介绍了一例复发缓解型多发性硬化症患者迅速转变为继发进展型病程的观察和治疗临床病例。给出了从2010年至2017年观察期内该患者临床表现动态分析（反映EDSS量表上的进展程度）、放射学研究数据分析以及一线和二线治疗药物处方分析。
