摘要
目的探讨不同糖皮质激素对重症肌无力（ｍｙａｓｔｈｅｎｉａｇｒａｖｉｓ，ＭＧ）患者的疗效。方法将２４３例ＭＧ按不同疗法分为５组：（１）胆碱脂酶抑制剂（ＣＨＥＩ）组；（２）ＣＨＥＩ＋强的松组；（３）ＣＨＥＩ＋强的松＋氢化可的松组；（４）ＣＨＥＩ＋强的松＋地塞米松组；（５）ＣＨＥＩ＋强的松＋甲基强的松龙组。比较各组疗效及平均起效时间。结果发现ＣＨＥＩ和皮质激素联合治疗的第４组疗效均优于单用ＣＨＥＩ组，而组（２）～组（５）比较，疗效无明显差异，但组（３）～（５）起效时间（分别为平均１５、１２、１１ｄ）均早于组（２）（平均４１ｄ）。还发现激素对激进重症型病例近期疗效并不差。短程激素冲击疗法出现一过性肌无力加重者较口服小剂量强的松疗法者多，但适当增加ＣＨＥＩ剂量后均很快渡过。结论大剂量激素短期冲击疗法对ＭＧ患者疗效肯定，以甲基强的松龙组起效最快，出现一过性肌无力最少。
Objective The aim of this study was to investigate the curative effect of GC on patients with MG. Methods 243 patients with MG were divided into 5 groups. (1) CHEI alone; (2) CHEI combined with predisone; (3) CHEI combined with cortisol and prednisone; (4) CHEI combined with dexamethasone and prednisone; (5) CHEI combined with methylprednisolone and prednisone. Results The curative effect of CHEI combinted with GC was better than that of CHEI alone. There were no significant differences of effect between group 2 and group 3, 4, 5. However, average manifest time of group 3 (15 days), group 4 (12 days), group 5 (11 days) was earlier than group 2 (41 days). Effect of GC on patient of Type Ⅲ. (osserman classification) was not bad, Short term GC pulse therapy caused more myasthenia than low dose of prednisone taken orally, but patients could go through transit if CHEI was increased properly. Conclusion It was effective of short term GC pulse therapy with large dose, in which methylprednisolone took effect most rapidly, with fewest corticoid myathnia.
出处
《中国神经免疫学和神经病学杂志》
CAS
1999年第2期105-109,共5页
Chinese Journal of Neuroimmunology and Neurology
