糖皮质激素联合丙种球蛋白或硫唑嘌呤治疗重症肌无力患儿的疗效及对T淋巴细胞亚群水平的影响  

Efficacy of glucocorticoid combined with gamma globulin or azathioprine for treating pediatric myasthenia gravis and its effect on T lymphocyte subsets levels

作　　者：黄诗琴 韩蕴丽[1] 刘敏[1] 李杏[1] 袁海[1] 陈晓兰[1] 夏巧巧 HUANG Shi-qin;HAN Yun-li;LIU Min;LI Xing;YUAN Hai;CHEN Xiao-lan;XIA Qiao-qiao(Department of Pediatrics,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院儿科

出　　处：《广西医学》2020年第2期152-155,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z20180965)

摘　　要：目的探讨糖皮质激素联合丙种球蛋白或硫唑嘌呤治疗重症肌无力(MG)患儿的疗效及其对T淋巴细胞亚群水平的影响。方法将60例MG患儿随机分为蛋白组与嘌呤组,各30例。两组均给予糖皮质激素治疗,同时蛋白组、嘌呤组分别给予大剂量静脉用丙种球蛋白、口服硫唑嘌呤治疗。比较两组患儿住院天数、治疗费用、不良反应发生情况、临床疗效,以及治疗前后的临床症状评分、CD4^+CD25^+T淋巴细胞水平。结果治疗后,两组患儿的临床症状评分、CD4^+CD25^+T淋巴细胞水平均较治疗前改善(均P<0.05),但两组间差异均无统计学意义(均P>0.05)。嘌呤组治疗费用低于蛋白组(P<0.05),但两组间住院时间、不良反应发生率、复发率、临床疗效比较,差异均无统计学意义(均P>0.05)。结论糖皮质激素联合丙种球蛋白或硫唑嘌呤均能有效地治疗MG儿童,并改善T淋巴细胞亚群水平,且疗效相当。Objective To explore the efficacy of glucocorticoid combined with gamma globulin or azathioprine for the treatment of pediatric myasthenia gravis(MG)and its effect on T lymphocyte subsets levels.Methods Sixty children with MG were randomized into globulin group or purine group,with 30 cases in each group.Both groups were administered glucocorticoid,concurrently,the globulin group was treated with high-dose intravenous immunoglobulin and the purine group with oral azathioprine.The following indicators were compared between the two groups:hospital stay,treatment costs,incidence of adverse reactions,clinical efficacy,as well as pre-and post-therapeutic clinical symptom scores and CD4^+CD25^+T lymphocyte levels.Results After treatment,the clinical symptom score and the CD4^+CD25^+T lymphocyte level were improved in both groups as compared with pre-therapy(all P<0.05),but there was no statistically significant difference between the two groups(all P>0.05).The purine group reported less treatment costs than the globulin group(P<0.05),whereas no statistically significant difference was found between the two groups in hospital stay,incidence rates of adverse reactions,recurrence rate,or clinical efficacy(all P>0.05).Conclusion Glucocorticoid combined with gamma globulin or azathioprine processes therapeutic effect on pediatric MG,and can improve the levels of T lymphocyte subsets,and achieves similar efficacy.

关 键 词：重症肌无力 丙种球蛋白 硫唑嘌呤 糖皮质激素 T淋巴细胞亚群 疗效 儿童 

分 类 号：R746.1[医药卫生—神经病学与精神病学]