摘要
目的 探讨门诊长期使用醋酸泼尼松治疗重症肌无力 (MG)的有效性、安全性和使用方法。方法 对 6 0 0例使用“泼尼松中剂量冲击、小剂量维持”口服疗法的MG患者进行前瞻性研究 ,观察泼尼松使用剂量、撤药方式与疗效和副反应的关系 ,并分析MG类型、年龄、病程及伴发病对疗效的影响。结果 追踪 1～ 12年 (平均约 4年 ) ,总有效率为 94.6 % ,终点的疗效与临床类型、发病年龄、病程及胸腺瘤无明显关联。 2 38例患者按计划撤药 ,有 82例 (34 .5 % )症状复发 (药物依赖 )。主要副反应为Cushing反应和易患上呼吸道感染。结论 泼尼松可用于所有类型MG的长期治疗 ,儿童及成人均适用。Cushing反应随药物减量逐渐消失 ,但易患上呼吸道感染和儿童体格矮小不容忽视。药物依赖的发生率很高 ,自制中成药扶正强筋片对此有一定帮助。
Objective The study was designed to evaluate the efficacy, safety, and applying method of long term prednisone therapy in treating the out patients with myasthenia gravis(MG). Methods From July 1983 to April 1998, six hundred myasthenic patients treated with short courses of moderate doses of daily prednisone and followed by low dose daily maintainance therapy had been followed up to study the efficacy, side effects, and dependence. The influences of clinical types, age at onest, duration of the disorder, and the accompanying disorders on efficacy had been analysed. Results During a mean follow up of nearly 4 years, the total effectiveness rate was 94.6%, and the efficacy had no relations with the clinical types, age at onset, duration of the disorder, and the accompanying disorders. The therapy was scheduled to withdraw in 238 cases after a stable remission for at least a year, and 82 out of them experienced recurrence of muscle weakness. The major side effects included Cushing′s reaction and the liability to suffer from respiratory tract infection. The underdevelopment of stature in children was also observed. Conclusions (1) Prednisone could be applied to the treatment of all types of MG. The children and adult sufferers could benefit from the therapy equally. (2) With the prednisone taper, Cushing′s reaction had become less apparent but the liability to suffer from the respiratory tract infection still remained a problem. (3) The concoction of Chinese herbs made by ourselves might be helpful in controlling recurrence.
出处
《中华神经科杂志》
CAS
CSCD
2000年第1期28-31,共4页
Chinese Journal of Neurology
