他克莫司治疗重症肌无力临床疗效及淋巴细胞亚群变化分析  

Clinical efficacy and lymphocyte subsets changes of tacrolimus for the treatment of Myasthenia Gravis

作　　者：夏聪[1] 楚兰[2] 张艺凡[2] 李媛[2] 陈美秋[1] 倪睿涵 况时祥[3] 

机构地区：[1]贵州医科大学神经病学教研室,贵州贵阳550004 [2]贵州医科大学附属医院神经内科,贵州贵阳550004 [3]贵阳中医学院第二附属医院神经内科,贵州贵阳550003

出　　处：《中风与神经疾病杂志》2017年第8期714-717,共4页Journal of Apoplexy and Nervous Diseases

基　　金：贵州省科技合作计划[黔科合LH字(2016)7251号];贵阳市人民政府-贵州医科大学联合基金[筑科合同(2016100)007号]

摘　　要：目的探讨他克莫司联合糖皮质激素治疗重症肌无力(MG)的临床疗效以及淋巴细胞亚群变化。方法将76例MG患者分为实验组(n=46)和对照组(n=30),实验组为他克莫司联合糖皮质激素治疗,对照组为糖皮质激素治疗。比较实验组与对照组许氏临床绝对评分、重症肌无力定量评分(QMGs)、淋巴细胞亚群。结果与治疗前相比,实验组治疗后1 m、3 m、6 m许氏临床绝对评分、QMGs均显著降低(P<0.05),CD4^+、CD19^+治疗后3 m、6 m也降低且具有统计学意义(P<0.05)。与对照组相比,实验组患者治疗后1 m许氏评分、QMGs具有明显差异(P<0.05),CD4^+治疗后3 m、6 m差异均有统计学意义(P<0.05)。结论他克莫司联合糖皮质激素比单独使用糖皮质激素早期症状改善明显,且对CD4^+抑制也更显著。Objective To investigate the clinical efficacy and impact on lymphocyte subsets of myasthenia gravis patients treated by tacrolimus combined with glucocorticoid. Methods A total of 76 cases of patients with myasthenia gravis were divided into observation group（ n = 46） and control group（ n = 30）. The clinical absolute scores,OMGs and lymphocyte subsets were compared between the two groups. Results Compared with before treatment,after 1,3 and 6 months of treatment,the clinical absolute scores and QMGs lowered obviously in observation group（ P〈0. 05）. After 3 and 6 months of treatment,CD4^＋and CD19^＋lowered obviously in observation group,the difference was significant（ P〈0. 05）. Compared with control group,after 1 months of treatment,the clinical absolute scores and QMGs lowered obviously in observation group,the difference was significant（ P〈0. 05）. After 3 and 6 months of treatment,CD4^＋and CD19^＋lowered obviously in observation group,the difference was significant（ P〈0. 05）. Conclusion In the early stage using tacrolimus combined with glucocorticoid can obviously alleviate the muscle weakness and descend CD4^＋.

关 键 词：重症肌无力 糖皮质激素 他克莫司 治疗 

分 类 号：R746.1[医药卫生—神经病学与精神病学]