环磷酰胺治疗伴胸腺瘤的重症肌无力临床研究  

Clinical evaluation of cyclophosphamide therapy in patients with myasthenia gravis and thymoma

作　　者：黄玲[1] 王磊[1] 尹世敏[1] 王佳楠[1] 陈红[1] 张红丽[1] 袁莉[1] 

机构地区：[1]第二炮兵总医院神经内科,北京100088

出　　处：《中国现代神经疾病杂志》2014年第10期878-882,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的观察环磷酰胺治疗伴胸腺瘤的重症肌无力的有效性和安全性。方法共95例伴胸腺瘤的重症肌无力患者,其中60例接受环磷酰胺0.20 g/次(2次/周)治疗,逐渐增加剂量至0.80 g/次(1次/周),当总剂量达6和10 g时,采用许氏评分法进行疗效评价并记录药物不良反应。结果与治疗前(19.65±8.90)相比,总剂量达6 g(13.73±8.63)和10 g(10.58±8.11)时临床绝对评分降低(均P<0.05),治疗总有效率为73.33%(44/60)和81.67%(49/60),药物不良反应轻微且可耐受。结论环磷酰胺治疗伴胸腺瘤的重症肌无力疗效显著且安全性良好,推荐在临床应用;药物安全性仍待进一步观察。Objective To evaluate the efficacy and safety of cyclophosphamide in the treatment ofpatients with myasthenia gravis（MG） and thymoma.MethodsNinety- five MG patients with thymomawere selected, and 60 of them were finally involved in the study. Patients were given low or median dose ofcyclophosphamide（0.20 g intravenously per day, twice a week）, and the dose was gradually increased to0.80 g intravenously per week. When the total dose of cyclophosphamide reached 6 and 10 g, the drugefficacy was respectively assessed by Clinical Absolute Score（CAS） and Clinical Relative Score（CRS）.Adverse events were also recorded.ResultsCompared with the score before treatment（19.65 ± 8.90）, theCAS after 6 g（13.73 ± 8.63） and 10 g（10.58 ± 8.11） cyclophosphamide treatment were significantly lowerthan that of before treatment（P〈0.05, for all）. The drug efficacy of the treatment was 73.33%（44/60） and81.67%（49/60） when the total dose reached 6 and 10 g, respectively. No serious adverse reactionsoccurred.ConclusionsCyclophosphamide is an effective and safe treatment for post- thymectomizedpatients with myasthenia gravis and thymoma. Further follow-up and study is still needed to evaluate thelong-term outcome.

关 键 词：重症肌无力 胸腺瘤 环磷酰胺 

分 类 号：R746.1[医药卫生—神经病学与精神病学]