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作者通过一项双盲对照交叉研究对运动神经元综合征病人静注免疫球蛋白(IVIg)进行了疗效观察。12例运动神经元综合征病人均伴有高滴定度抗GM_1抗体,平均年龄42.1岁(19～63岁)。根据运动 神经元紊乱情况,将病人分为多发性运动神经病(MMN)组及下运动神经元综合征(LMNS)组。所有病人均进行了肌电图检查,由酶联免疫吸附试验测定血清抗GM_1抗体滴度。根据双盲交叉设计,分别给予病人IVIg(0.4g/kg/d;连续5天)或生理盐水,在第一阶段治疗8周后进行第二阶段治疗。在试验前3个月及试验期间病人均未用过免疫抑制剂,给药前和给药后第5、28和56天分别测定下列四项:(1)肌力,(2)病人劳动力丧失程度,(3)运动神经传导速度,(4)免疫参数:抗GM_1抗体、免疫复合物及CD_2、CD_4、CD_8淋巴细胞。
The authors performed a double-blind, controlled cross-over study of IVIg in patients with motor neuron syndrome. All 12 patients with motor neuron syndrome were accompanied by high titer of anti-GM_1 antibody with an average age of 42.1 years (range, 19-63 years). According to the disorder of motor neurons, patients were divided into multiple motor neuropathy (MMN) group and lower motor neuron syndrome (LMNS) group. All patients underwent EMG examination, serum anti-GM1 antibody titers were measured by enzyme-linked immunosorbent assay. Patients were given IVIg (0.4 g / kg / d; 5 consecutive days) or saline, respectively, according to a double-blind crossover design. Stage two treatment was performed after the first phase of treatment for eight weeks. None of the patients used immunosuppressant during the first 3 months of the test and during the test. The following four items were determined before administration and on days 5, 28 and 56 after administration: (1) strength, (2) loss of patient labor (3) motor nerve conduction velocity, (4) immune parameters: anti-GM1 antibody, immune complexes and CD2, CD4, CD8 lymphocytes.