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[慢性炎症性脱髓鞘性多发性神经病各亚型的临床及长期特征]

[Clinical and long-term characteristics of the subtypes of chronic inflammatory demyelinating polyneuropathy].

作者信息

Shimizu Fumitaka, Nemoto Jo, Takeshita Yukio, Maeda Toshihiko, Koga Michiaki, Kanda Takashi

机构信息

Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine.

出版信息

Rinsho Shinkeigaku. 2022 Mar 29;62(3):173-177. doi: 10.5692/clinicalneurol.cn-001667. Epub 2022 Mar 25.

Abstract

OBJECTIVE

To clarify the clinical and long-term characteristic of each subtype of chronic inflammatory demyelinating polyneuropathy (CIDP).

METHODS

We evaluated data from 30 consecutive CIDP patients who met the criteria proposed by the European Federation of Neurological Societies and the Peripheral Nerve Society.

RESULTS

Patients were classified as having typical CIDP (t-‍CIDP) (10/30, 33%), multifocal acquired demyelinating sensory and motor (MADSAM) (12/30, 40%), DADS (4/30, 13%), sensory CIDP (3/30, 10%) or motor CIDP (1/30, 3%). Nerve conduction studies showed more prolonged distal motor latencies/F-wave latencies and slower motor nerve conduction in the typical CIDP group than in the MADSAM group. Intravenous immunoglobulin (IVIg) was effective in 80% (8/10) of t-‍CIDP, 100% (12/12) of MADSAM, 100% (4/4) of DADS, and 100% (3/3) of sensory CIDP cases. Maintenance therapy with immunoglobulin was administered in patients with t-‍CIDP (5/10, 50%), MADSAM (9/12, 75%), DADS (1/4, 25%), and sensory CIDP (2/3, 67%). There were no patients with CIDP, in whom CIDP subtype was transformed from the initial diagnosis during five years of follow-up.

DISCUSSION

Percentage of MADSAM was the most common phenotype in our cohort of CIDP patients, and IVIg/immunoglobulin maintenance was effective for MADSAM as well as t-‍CIDP in contrast to findings from the previous reports.

摘要

目的

阐明慢性炎症性脱髓鞘性多发性神经病(CIDP)各亚型的临床及长期特征。

方法

我们评估了连续30例符合欧洲神经病学学会联合会和周围神经学会提出标准的CIDP患者的数据。

结果

患者被分类为典型CIDP(t-CIDP)(10/30,33%)、多灶性获得性脱髓鞘性感觉和运动性神经病(MADSAM)(12/30,40%)、远端获得性脱髓鞘性对称性神经病(DADS)(4/30,13%)、感觉性CIDP(3/30,10%)或运动性CIDP(1/30,3%)。神经传导研究显示,典型CIDP组的远端运动潜伏期/F波潜伏期延长更明显,运动神经传导速度比MADSAM组更慢。静脉注射免疫球蛋白(IVIg)对80%(8/10)的t-CIDP、100%(12/12)的MADSAM、100%(4/4)的DADS和100%(3/3)的感觉性CIDP病例有效。t-CIDP(5/10,50%)、MADSAM(9/12,75%)、DADS(1/4,25%)和感觉性CIDP(2/3,67%)患者接受了免疫球蛋白维持治疗。在随访的五年中,没有CIDP患者的CIDP亚型从初始诊断转变。

讨论

MADSAM是我们CIDP患者队列中最常见的表型,与先前报道的结果相反,IVIg/免疫球蛋白维持治疗对MADSAM和t-CIDP均有效。

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