摘要
目的了解大剂量糖皮质激素(GC)冲击为主综合治疗重症肌无力(MG)的疗效及副作用。方法应用临床评分随访观察64例大剂量GC冲击后短程激素加综合治疗、83例大剂量GC冲击后长程激素加综合治疗和70例非GC冲击治疗患者的病情变化及副作用。结果治疗1个月时的有效率短程组为89．06％,长程组为89．16％,对照组为70．00％;改善幅度短程组为64．62％土27．06％,长程组为65．62％±27．21％,对照组为48．35％±32．09％;加用其他免疫抑制剂继续治疗6个月时,有效率依次为短程组93．76％、长程组93．98％、对照组82．85％;改善幅度短程组为72.16％±26．95％,长程组为73．06％±24.74％,对照组为56．31％±32．08％,在治疗1个月和6个月时,短程组和长程组相对评分差异均无统计学意义;GC副作用长程组明显多于短程组(P<0．05)．结论大剂量GC冲击后短程激素加综合治疗MG与大剂量GC冲击后长程综合治疗MG疗效相当,均好于对照组,但GC冲击后短程激素并综合治疗组副作用低于长程组。
Objective To investigate the therapeutic effects and side effects of high-dose glucocorticoid （GC） in patients with myasthenia gravis （MG）. Methods 64 MG patients were treated with high-dose GC followed by a short course of small-dose of GC （short regimen group）, compared with 83 MG patients treated with high-dose GC followed by a long course of small-dose of GC （ long regimen group） and 70 MG patients treated with such immunosuppressant as azathioprine, cyclin A, cyclophosphamide other than high-dose GC （controlled group）. All MG patients treated with GC are treated with other immunosupressants at the same time. The clinical score was recorded and used to assess the therapeutic the effects. Results The treatment regimen of high-dose GC followed by a short course of small-dose of GC was effective in treating MG. The improving rate was 89. 06%, 89. 16% and 70. 00% respectively and relative score was 64. 62% ±27.06% , 65.62% ±27. 21% , and 48. 35% ±32. 09% in short regimen group, long regimen group and control group after treated for 1 month. The improving rate was 93.76%, 93. 98% and 82. 85% respectively and relative score was 72. 16% ± 26. 95% , 73.06% ± 24. 74% , and 56. 31% ± 32. 08% in short regimen group, long regimen group and controlled group after treated for 6 months. There was no therapeutic difference between short regimen group and long regimen group （ P 〉 0. 05 ）. There were less side effects in short regimen group compared with long regimen group （ P 〈 0. 05 ）. Conclusion Both short and long GC regimens combined with immunosupressants are superior to that without GC in treatig MG, and the former brings about less side effects.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2006年第8期511-515,共5页
Chinese Journal of Neurology
基金
国家自然科学基金资助项目(30571707)
关键词
重症肌无力
糖皮质激素类
综合疗法
Myasthenia gravis
Glucocorticoids
Combined modality therapy
