甲基强的松龙冲击疗法抢救失明的小儿急性视神经炎的临床研究  

The clinical research of blind child acute optic neuritis treated with methylprednisolone pulse therapy

作　　者：刘伦[1] 陈积中[1] 夏卫东[1] 宋汝庸[2] 

机构地区：[1]安徽医科大学第一附属医院眼科,合肥230022 [2]安徽省立医院眼科,合肥230001

出　　处：《安徽医科大学学报》2001年第6期469-472,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的　评价甲基强的松龙冲击疗法抢救失明的小儿急性视神经炎的疗效。方法　小儿组 :选择无肾上腺皮质激素禁忌症的失明小儿急性视神经炎 2 2例 (34眼 )为研究对象。用大剂量甲基强的松龙静脉滴注 ,每天剂量按小儿公斤体重计算。每天 1次 ,3～ 5天为 1疗程。以后再用常规疗法。成人组 :选择无肾上腺皮质激素禁忌症的失明成人急性视神经炎 16例 (2 4眼 )为对照组。甲基强的松龙 5 0 0～10 0 0mg静脉滴注 ,每天 1次 ,3～ 5天为 1疗程。以后再用常规疗法。结果　小儿组 :显效 (视力提高至 0 5～ 1 0 ) 2 2眼 ,占 6 4 7% ;有效 (视力提高至 0 1～ 0 4) 9眼 ,占 2 6 5 % ;总有效率 :91 2 % ;无效 (指数 ) :3眼 ,占 8 8%。成人组 :评价疗效标准与小儿组相同。显效 :9眼 ,占 37 5 % ;有效 :7眼 ,占 2 9.17% ;总有效率 :6 6 6 7% ;无效 :8眼 ,占 33 33%。两组疗效有差异 (P <0 0 2 5 )。结论　甲基强的松龙冲击疗法治疗失明小儿急性视神经炎 ,作用迅速可靠 ,疗效高 ,未发现副作用 ,随访无复发。Objective To evaluate the effects of methylprednisolone pulse therapy (MPPT) on the blind child acute optic neuritis. Methods 1. Child group: 22 cases(34 eyes) of blind children with acute optic neuritis who have no contraindication with steroid were treated with MPPT. The dose was calculated by children’s weights. Methylprednisolone was given intravenously once daily for 3 to 5 days, followed by general treatment. 2. Adult group: 16 cases(24 eyes) of blind adult acute optic neuritis without contraindication with steroid were chosen as a control group. They were treated with methylprednisolone intravenously 500～1000 mg daily for 3 to 5 days, followed by general treatment. Results (1) Child group: obviously effective: 22 eyes(64.7%) attained visual acuity of 0.5 or better, effective: 9 eyes(26.5%) attained visual acuity of 0.1～0.4,total effective rate was up to 91.2%, no effect: 3 eyes(8.8%). (2)Adult group: The evaluation standard is the same as the children group. Obviously effective: 9 eyes(37.5%);effective: 7 eyes(29.17%),total effective rate 66.67%,no effect:8 eyes(33.33%). The statistical difference between two groups is significant(P<0.025). Conclusion MPPT is an effective and a reliable method in treatment of bilateral blind child acute optic neuritis.

关 键 词：甲泼尼松龙 治疗 视神经炎 药物疗法 儿童 

分 类 号：R977.11[医药卫生—药品] R744.61[医药卫生—药学]