目的：报道激素联合环磷酰胺治疗视神经脊髓炎谱系疾病患者1例，并对相关文献进行复习。
方法：对1例诊断为视神经脊髓炎谱系疾病患者进行相关实验室检查（包括水通道蛋白4）和辅助检查，并基于临床实践，给予激素联合环磷酰胺治疗。
结果：该患者以渐进性右眼视物模糊伴右侧肢体无力、麻木起病，诊断为视神经脊髓炎谱系疾病。治疗方面，先给予激素冲击治疗，但患者病情不断进展且对激素产生依赖性，遂加用环磷酰胺，使患者的病情得到了有效控制。
结论：对于视神经脊髓炎谱系疾病激素治疗不佳的患者，激素联合环磷酰胺治疗可以明显改善其临床症状。
Abstract
Objective: To report one patient diagnosed of neuromyelitis optica spectrum disorder (NMOSD) receiving treatment with steroid combined with cyclophosphamide, and review the related literatures.
Methods: Laboratory examinations (including aquaporin-4 detection) and adjuvant examinations were performed on one patient with NMOSD, and the treatment with steroid combined with cyclophosphamide based on clinical practice was administrated.
Results: The patient suffered from progressive blurred vision of the right eye, accompanied by the weakness and numbness of the right limb, and was diagnosed of NMOSD. For treatment, this patient received steroid pulse therapy immediately after the NMOSD was confirmed, but the patient’s condition continued to progress and developed steroid-dependence. Then the cyclophosphamide was added and the patient’s condition was effectively controlled.
Conclusion: There is a significant benefit in NMOSD patients who are treated with steroid combined with cyclophosphamide when the only steroid treatment is ineffective.
关键词
视神经脊髓炎谱系疾病 /
水通道蛋白4 /
类固醇 /
环磷酰胺
Key words
Neuromyelitis optica spectrum disorder /
Aquaporin-4 /
Steroid /
Cyclophosphamide
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参考文献
[1] Lennon VA, Wingerchuk DM, Kryzer TJ, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis[J]. Lancet, 2004, 364(9451):2106-2112.
[2] 吕传真. 神经病学[M]. 上海: 上海科学技术出版社, 2015:259-260.
[3] Vincent T, Saikali P, Cayrol R, et al. Functional consequences of neuromyelitis optica-IgG astrocyte interactions on blood-brain barrier permeability and granulocyte recruitment[J]. J Immunol, 2008, 181(8):5730-5737.
[4] Varrin-Doyer M, Spencer CM, Schulze-Topphoff U, et al. Aquaporin 4-specific T cells in neuromyelitis optica exhibit a Th17 bias and recognize Clostridium ABC transporter[J]. Ann Neurol, 2012, 72(1):53-64.
[5] Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders[J]. Neurology, 2015, 85(2):177-189.
[6] 王瑞金, 齐 冬, 张拥波. 视神经脊髓炎谱系疾病1例报道并文献复习[J]. 中国临床神经科学, 2016, 24(3):324-327, 347.
[7] 杨晶晶, 曹 洁. 视神经脊髓炎治疗研究进展[J]. 儿科药学杂志, 2015, 21(5):54-57.
[8] 顾小花, 徐俊. 循证指导治疗视神经脊髓炎1例临床报告[J]. 中国实用内科学, 2013, 33(11):907-909.
[9] 胡学强, 神经免疫性疾病新进展[M]. 广州: 中山大学出版社, 2016:70-72.
[10] 樊永平, 胡 蕊, 吴 畏, 等. 63例视神经脊髓炎患者临床特点和中医证型分布[J]. 中国中西医结合杂志, 2013, 33(3):322-325.
[11] 朱丽莉, 倪光夏, 王和生. 针药结合治疗视神经脊髓炎1例报告[J]. 新中医, 2008, 40(1):113.
[12] 杨仁青, 张桂兰. 针刺治疗视神经脊髓炎28例[J]. 中国针灸, 1994, 13(2):13-14.
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