重视常见神经免疫疾病激素冲击治疗和减量方案的规范性  

High-dose glucocorticoid pulse therapy and dosage reduction regimen in acute attack of neuroimmune diseases

作　　者：陈嘉欣 冯慧宇[1] Chen Jiaxin;Feng Huiyu(Department of Neurology,the First Affiliated Hospital,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院神经科,广东省重大神经疾病诊治研究重点实验室,广州510080

出　　处：《中华神经科杂志》2021年第9期876-884,共9页Chinese Journal of Neurology

基　　金：华南神经疾病早期干预及功能修复研究国际合作基地项目(2015B050501003)。

摘　　要：糖皮质激素冲击治疗是神经系统免疫性疾病急性期诱导缓解的重要手段。但目前国内各医院激素冲击治疗的具体方案并不规范和统一,与国内外指南推荐其去弥远。文中将近10年国内外常见的神经免疫疾病诊治指南中关于疾病急性期的激素治疗方案进行了总结。其中激素冲击治疗一般都遵循大剂量和短疗程原则,以静脉使用甲泼尼龙1000 mg/d,连续3~5 d为最常用方案。冲击治疗后的减量方案,依据疾病的种类及特点,减量速度及注意事项有所不同。规范化激素冲击治疗既能最大限度地发挥其疗效,又能减少相关不良反应的发生,值得临床医生关注和重视。Glucocorticoid pulse therapy is an important means to induce remission of neuroimmune diseases in acute attack stage.However,the specific programs of glucocorticoid pulse therapy in domestic hospitals are not standardized and unified at present.Here,glucocorticoid pulse therapy in acute attack of neuroimmune diseases in national and international guidelines in last decade are reviewed and summarized.Glucocorticoid pulse therapy follows the principle of large dosage and short course of treatment,and intravenous methylprednisolone 1000 mg/d for three days to five days is the most common regimen.According to the characteristics of diseases,the dosage reduction regimens are different.Standardized glucocorticoid pulse therapy can not only maximize its curative effects,but also minimize its side effects,which deserves the attention of clinicians.

关 键 词：糖皮质激素 冲击治疗 神经系统 自身免疫性疾病 

分 类 号：R741[医药卫生—神经病学与精神病学]