方法：回顾性病例研究。收集2017-01/2019-12收治的AQP4抗体阳性NMOSD患者11例，其中男3例，女8例。NMOSD特有的重要临床表现为视神经炎。发病平均年龄36.3±6.0(27～47)岁，平均病程3.4±1.4(2.2～6.8)a。在NMOSD缓解期加用MMF 1a或1a以上。记录应用MMF患者的年复发率(ARR)、最佳矫正视力(BCVA)和不良反应。

结果：MMF治疗的中位时间为18(12，36)mo。ARR在基线时为0.66/a，治疗后为0.16/a。91%的患者ARR下降，82%的患者无临床复发。MMF治疗后ARR明显改善(P<0.05)。治疗后平均BCVA与治疗前比较无显著差异(P>0.05)。11例患者中，3例(27%)出现不良反应，其中1例(9%)出现转氨酶升高，2例(18%)出现轻度胃肠道反应。没有因不良反应而停用MMF的情况。

结论：MMF治疗AQP4抗体阳性NMOSD患者能在一定程度上降低其视神经炎的ARR，保护患者的视功能。

METHODS: We retrospectively reviewed 11 patients with initial diagnosis of NMOSD and AQP4 antibody positive optic neuritis from January 2017 to December 2019. Among the 11 patients, 3 were male and 8 were female. The unique core clinical manifestation of NMOSD was optic neuritis. The onset age was 36.3±6.0(27-47)years old. Duration of the disease was 3.4±1.4(2.2-6.8)a. MMF was added in the relieving period of NMOSD for 1a or over 1a. Annualized relapsing rate(ARR), best corrected vision activity(BCVA)and adverse reactions of MMF were recorded.

RESULTS: The median time of MMF treatment was 18(12, 36)mo. The ARR was 0.66/a at baseline and 0.16/a after the treatment. There were 91% of the patients had decreased ARR and 82% of them had no clinical relapse. The patients had significant improvement on ARR after MMF treatment(P<0.05 ). In total, there was no significant difference between the mean BCVA after treatment and that at baseline(P>0.05). Of the 11 patients, 3 patients had side effects(27%), including 1 patient with elevated liver transaminase(9%), and 2 patients with mild gastrointestinal reaction(18%)during follow-up period. None of them discontinued MMF due to adverse events.

CONCLUSION: MMF treatment for AQP4 antibody positive NMOSD can reduce the ARR of optic neuritis to a certain extent and protect the visual function of patients.