PDF(Pubmed)
Abstract：
Background: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system (CNS) that prompts immediate potent treatment. Delaying treatment could leave debilitating sequelae. As erythropoietin (EPO) has shown neuroprotective effects, we studied the effects of adding EPO to intravenous methylprednisolone (IVMP) in patients with acute attacks of NMOSD. Methods: NMOSD cases with acute attacks were included. Cases of optic neuritis (ON) and those with myelitis were separated. After randomization [with block sizes of 2 (1:1 ratio)], the patients in the intervention group received IVMP 1000 mg/day and intravenous (IV) EPO 20000 U/day for five days. IVMP 1000 mg/day and normal saline (NS) were administered in the control group. Staged eye score and motor forces were evaluated in the patients with ON and myelitis, respectively, at the time of the attack and three months later. Primary patient allocation and clinical assessments were blinded to the physicians. Results: Mean age of participants was 53.87 ± 11.53 years. At follow-up, in the ON arm, the median improvement in staged eye score was 2 in the control and 5 in the intervention group. The difference was significant (P < 0.001). In the myelitis group, none of the patients in the control group had improvement in motor forces. All the patients in the intervention group showed substantial improvement with minimal or no remaining weakness. The difference was statistically significant (P = 0.029). Conclusion: The results show the possible benefit of adding EPO to the classic IVMP in attacks of NMOSD in both visual and motor aspects.
摘要：
背景：视神经脊髓炎谱系障碍（NMOSD）是中枢神经系统（CNS）的自身免疫性疾病，提示立即有效治疗。延迟治疗可能会留下使人衰弱的后遗症。促红细胞生成素（EPO）已显示出神经保护作用，我们研究了NMOSD急性发作患者在静脉注射甲泼尼龙(IVMP)中加入EPO的效果.方法：纳入急性发作的NMOSD病例。分离了视神经炎（ON）和脊髓炎的病例。随机化后[块大小为2（1：1比例）]，干预组患者接受IVMP1000mg/天和静脉(IV)EPO20000U/天,共5天.对照组给予IVMP1000mg/天和生理盐水(NS)。在ON和脊髓炎患者中评估了阶段性的眼睛评分和运动力，分别,袭击发生时和三个月后。主要患者分配和临床评估对医生是盲目的。结果：参与者的平均年龄为53.87±11.53岁。在后续行动中,在ON臂中，对照组和干预组的阶段性眼部评分中位数改善为2,干预组为5.差异有统计学意义(P<0.001)。在脊髓炎组中，对照组中没有患者的运动力得到改善.干预组的所有患者均表现出明显的改善，几乎没有或没有剩余的弱点。差异有统计学意义(P=0.029)。结论：结果表明，在视觉和运动方面的NMOSD发作中，将EPO添加到经典IVMP中可能具有益处。
