不同剂量糖皮质激素冲击治疗风湿病的临床观察  

Clinical observational study of the effect of different doses of glucocorticoids impact treatment for rheumatism

作　　者：尚健[1] 昌路艳 姚合斌[1] 康怡[1] 陈亚宁[1] 

机构地区：[1]海军总医院内分泌风湿免疫科,北京100048

出　　处：《中国医学装备》2016年第5期120-123,共4页China Medical Equipment

摘　　要：目的:观察大剂量糖皮质激素治疗重症风湿性疾病的临床疗效以及不良反应。方法:选取64例住院期间经不同大剂量糖皮质激素冲击治疗的急危重风湿性疾病住院患者,根据激素冲击剂量将其分为A组(54例)与B组(10例)。A组采用甲泼尼龙琥珀酸钠(0.5~1.0 g/d)治疗3 d;B组采用甲泼尼龙琥珀酸钠(0.25 g/d)治疗3 d。统计分析治疗前、后患者的临床表现、炎性指标以及近期内发生的不良反应,比较两组治疗的有效率及不良反应发生率。结果:1治疗后A组患者与B组患者不良反应发生率相比较无差异;2治疗后A组患者与B组患者的有效率比较,差异有统计学意义(x^2=4.235,P<0.05)。结论:给予更大剂量糖皮质激素治疗,其不良反应无明显增加,对于急危重风湿性疾病,急需糖皮质激素冲击治疗的患者,给予500 mg或1 g剂量连续3 d冲击,可以更快、更有效的控制病情进展。Objective：To observe the therapeutic effect and adverse reactions of high-dose glucocorticoids therapy on severe rheumatism.Methods： Sixty-four critical rheumatic disease inpatients who were treated with high-dose glucocorticoids in the endocrinology department, were divided into 2 groups according to the doses of hormone： group A： received methylprednisolone sodium succinate 0.5~1.0g/d for three days （54cases）, group B： received methylprednisolone sodium succinate 0.25g/d for three days （10 cases）. The clinical manifestations, inflammatory indexes and adverse reactions of patients were collected before and after the treatment. The incidence of adverse reactions and the efficacy of the two groups were compared.Results： （1）There was no significant statistical significance between two groups in the incidences of adverse reactions. （2）The difference was statistically significant in the efficacy between Group A and Group B, （x2=4.235,P〈0.05）.Conclusion： The adverse reactions do not increase significantly for critical rheumatoid disease after use of higher dose of glucocorticoids for treatment. Given 500 mg or 1g dose for 3 consecutive days, the severe progression of critical rheumatoid disease who is in urgent and need of high-dose glucocorticoids treatment, can be control faster and more effectively.

关 键 词：风湿性疾病 激素冲击 疗效 

分 类 号：R593.21[医药卫生—内科学]