Lopate G, Pestronk A
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110.
Semin Neurol. 1994 Jun;14(2):131-6. doi: 10.1055/s-2008-1041070.
The classification of immune-mediated demyelinating polyneuropathies has become more complex in recent years. Initial definitions of chronic inflammatory demyelinating polyneuropathy (CIDP) were often broad enough to include almost any acquired polyneuropathy with demyelinating features. However, subdivision of acquired demyelinating polyneuropathies into different categories seems justified because 1) several distinct clinical syndromes have been identified, 2) characteristic and distinctive patterns of serum antibody binding are associated with each specific clinical syndrome and, 3) the syndromes respond differently to immune modulating treatments (Table 1). Larger series and controlled trials will be necessary to determine the therapeutic regimens that optimize the benefit:risk considerations for patients with these syndromes.
近年来,免疫介导的脱髓鞘性多发性神经病的分类变得更加复杂。慢性炎症性脱髓鞘性多发性神经病(CIDP)最初的定义往往宽泛到足以囊括几乎任何具有脱髓鞘特征的后天性多发性神经病。然而,将后天性脱髓鞘性多发性神经病细分为不同类别似乎是合理的,因为:1)已识别出几种不同的临床综合征;2)每种特定临床综合征都有其特征性和独特的血清抗体结合模式;3)这些综合征对免疫调节治疗的反应不同(表1)。需要更大规模的系列研究和对照试验来确定能优化获益风险比的治疗方案,以用于这些综合征患者。