中国实用神经疾病杂志2025，Vol.28Issue(6)：756-761,6.DOI:10.12083/SYSJ.240124
甲泼尼龙分别联合利妥昔单抗和免疫球蛋白治疗自身免疫性脑炎的倾向性评分匹配对比研究
Comparative study of methylprednisolone combined with rituximab and immunoglobulin in the treatment of autoimmune encephalitis:a propensity score matching
摘要
Abstract
Objective To compare the efficacy of methylprednisolone combined with rituximab and immunoglobulin in the treatment of autoimmune encephalitis.Methods Totally 100 patients with autoimmune encephalitis treated in Liaocheng People's Hospital from October 2021 to October 2024 were selected as study objects,and were divided into rituximab group and immunoglobulin group,with 50 cases in each group.The rituximab group was treated with methylprednisolone combined with rituximab,and the immunoglobulin group was treated with methylprednisolone combined with immunoglobulin.Propensity score matching method was used to balance confounding factors between the two groups,and 42 cases in the rituximab group and 42 cases in the immunoglobulin group were included.The therapeutic effects of the two groups were recorded,and the patients were evaluated using the mini-mental state examination(MMSE)scale and Montreal cognitive assessment scale(MoCA).The changes of cytokines(tumor necrosis factor α(TNF-α),interferon γ(IFN-γ),neuron-specific enolase(NSE))and T cell subsets(CD4+,CD8+,CD4+/CD8+)before and after treatment were compared between the two groups,and the occurrence of adverse reactions were statistically analyzed.Results A total of 42 pairs were successfully matched after propensity score matching analysis.The total effective rate of the immunoglobulin group was higher than that of the rituximab group(97.62%vs 83.33%,P<0.05).After treatment,MMSE and MoCA scores increased in both groups,and the immunoglobulin group was higher than the rituximab group(P<0.05).After treatment,the levels of TNF-α,IFN-γ and NSE decreased in both groups,and the changes in the immunoglobulin group were more significant than those in the rituximab group(P<0.05).After treatment,CD4+and CD4+/CD8+levels increased and CD8+levels decreased in both groups,and the changes in the immunoglobulin group were more significant than those in the rituximab group(P<0.05).Conclusion Compared with methylprednisolone combined with rituximab,methylprednisolone combined with immunoglobulin has better efficacy in the treatment of patients with autoimmune encephalitis,which can help to improve the mental state and cognitive function,balance the serum cytokines and immune levels.关键词
自身免疫性脑炎/甲泼尼龙/利妥昔单抗/免疫球蛋白/倾向性评分匹配法Key words
Autoimmune encephalitis/Methylprednisolone/Rituximab/Immunoglobulin/Propensity score matching method分类
医药卫生引用本文复制引用
于洋,郭燕,李宁宁,郑娟..甲泼尼龙分别联合利妥昔单抗和免疫球蛋白治疗自身免疫性脑炎的倾向性评分匹配对比研究[J].中国实用神经疾病杂志,2025,28(6):756-761,6.基金项目
山东中医药科技项目(编号:2019-0896) （编号:2019-0896）
