2025 年第 8 期 第 20 卷

甲泼尼龙冲击治疗联合鼠神经生长因子对急性视神经炎患者视力及自身免疫性抗体水平的影响

The effect of methylprednisolone pulse therapy combined with mouse nerve growth factor on visual acuity and autoimmune antibodies levels in patients with acute optic neuritis

作者：陈鹏1赵欣2邵陈沙3

英文作者：Chen Peng1 Zhao Xin2 Shao Chensha3

单位：1河北大学附属医院眼科，保定071000；2河北省石家庄市第三医院眼科，石家庄050000；3河北省保定市第一中心医院眼一科，保定071000

英文单位：1Department of Ophthalmology Affiliated Hospital of Hebei University Baoding 071000 China; 2Department of Ophthalmology the Third Hospital of Shijiazhuang Hebei Province Shijiazhuang 050000 China; 3First Department of Ophthalmology Baoding No.1 Central Hospital Hebei Province Baoding 071000 China

关键词：急性视神经炎；甲泼尼龙；鼠神经生长因子；视力；自身免疫性抗体

英文关键词：Acuteopticneuritis;Methylprednisolone;Mousenervegrowthfactor;Visualacuity;Autoimmuneantibodies

• 摘要：

• 目的 探究甲泼尼龙冲击治疗联合鼠神经生长因子对急性视神经炎患者视力及自身免疫性抗体水平的影响。方法 选取2023年7月至2024年6月河北大学附属医院收治的122例急性视神经炎患者作为研究对象，按照随机数字表法分为对照组（61例）和观察组（61例）。2组患者均先给予常规治疗，对照组额外给予鼠神经生长因子治疗，观察组在对照组基础上给予甲泼尼龙冲击治疗，2组均治疗4周。比较2组患者的治疗效果、视力、视功能指数、视野缺损值、自身免疫性抗体、视觉诱发电位、不良反应发生率、复发率。结果 观察组治疗总有效率高于对照组［91.8%（56/61）比77.0%（47/61）］，差异有统计学意义（χ2=5.050，P=0.025）。治疗后，2组视力、视功能指数、P100波振幅均高于/大于治疗前，且观察组均高于/大于对照组；2组视野缺损值、髓鞘少突胶质细胞糖蛋白阳性率、水通道蛋白4阳性率、P100波潜伏期均低于/短于治疗前，且观察组均低于/短于对照组，差异均有统计学意义（均P＜0.05）。2组不良反应发生率比较差异无统计学意义（χ2=0.684，P=0.408）。观察组复发率低于对照组［8.2%（5/61）比21.3%（13/61）］，差异有统计学意义（χ2=4.171，P=0.041）。结论  甲泼尼龙冲击治疗联合鼠神经生长因子治疗急性视神经炎的效果显著，能有效提升视力、改善视神经的功能、减轻免疫反应。

• Objective To investigate the effect of methylprednisolone pulse therapy combined with mouse nerve growth factor on visual acuity and autoimmune antibodies levels in patients with acute optic neuritis. Methods A total of 122 patients with acute optic neuritis admitted to Affiliated Hospital of Hebei University from July 2023 to June 2024 were selected as the research objects. According to the random number table method, they were divided into the control group (61 cases) and the observation group (61 cases). Both groups were given conventional treatment first, the control group was given mouse nerve growth factor, and the observation group was given methylprednisolone pulse therapy on the basis of the control group, both groups were treated for 4 weeks. The curative effect, visual acuity, visual function index, visual field defect value, autoimmune antibody, visual evoked potential, incidence of adverse reactions and recurrence rate were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group ［91.8%(56/61) vs 77.0%(47/61)］(χ2=5.050, P=0.025). After treatment, the visual acuity, visual function index and P100 wave amplitude of the two groups were higher/greater than those before treatment, and those of the observation group were higher/greater than those of the control group; the visual field defect value, positive rate of myelin oligodendrocyte glycoprotein, positive rate of aquaporin 4, and P100 wave latency in the two groups were lower/shorter than those before treatment, and those in the observation group were lower/shorter than those in the control group (all P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.684, P=0.408). The recurrence rate of the observation group was lower than that of the control group ［8.2%(5/61) vs 21.3%(13/61)］(χ2=4.171, P=0.041). Conclusion Methylprednisolone pulse therapy combined with mouse nerve growth factor has a significant effect on acute optic neuritis, which can effectively improve visual acuity, improve the function of the optic nerve, and reduce the immune response.