静脉注射人免疫球蛋白治疗全身型重症肌无力的短期疗效观察  

Short-term efficacy of intravenous immunoglobulin in generalized myasthenia gravis:a retrospective study

作　　者：殷剑[1] 王红[1] 闻洁曦 宋江曼 侯世芳[1] 张华[1] YIN Jian;WANG Hong;WEN Jiexi;SONG Jiangman;HOU Shifang;ZHANG Hua(不详;Department of Neurology,Beijing Hospital,National Center of Gerontology,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院神经科,国家老年医学中心,中国医学科学院老年医学研究院,100730 [2]航天731医院神经科

出　　处：《中国神经免疫学和神经病学杂志》2022年第1期27-30,共4页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的观察静脉注射人免疫球蛋白(intravenous immunoglobulin,IVIg)治疗全身型重症肌无力(myasthenia gravis,MG)的短期临床疗效、安全性。方法纳入2016年1月至2019年9月期间北京医院就诊的58例Osserman分型Ⅱb及以上的全身型MG患者。收集患者一般信息、入院诊断、治疗用药情况,采用许氏绝对与相对评分法(the absolute and relative score of MG,ARS-MG)评估患者IVIg治疗前及治疗后7、14 d临床症状的改善情况,并比较不同年龄(<60岁和≥60岁)、病程(≤1年和>1年)以及有无构音障碍、咀嚼障碍、呼吸困难者间IVIg疗效的差异。结果58例MG患者IVIg治疗后第7天许氏评分较治疗前降低〔(17.21±10.52)分比(23.22±10.45)分,P<0.01〕。IVIg治疗7 d时其总有效率为48.28%(n=58),治疗后14 d其总有效率为59.46%(n=37)。不同年龄、病程以及有无构音障碍、咀嚼障碍、呼吸困难者间IVIg疗效比较无统计学差异(均P>0.05)。所有患者未出现严重不良反应。结论IVIg治疗OssermanⅡb型及以上MG患者短期疗效显著,起效快,安全性高。Objective To evaluate the short-term efficacy and safety of intravenous immunoglobulin(IVIg)in the treatment of generalized myasthenia gravis.Methods 58 myasthenia gravis patients with Osserman typeⅡb and above admitted to Beijing Hospital from January 2016 to September 2019 that met the research criteria were included in this study.General information,admission diagnosis,treatment and medication records were collected.The absolute and relative scores of myasthenia gravis(ARS-MG)were used to measure the clinical symptoms of the patients before and after IVIg treatment.Besides,we compared the efficacy of IVIg among patients with different age(<60 years old and≥60 years old),different disease course(≤1 year and>1 year),and whether they had dysarthria,masticatory disorder and dyspnea.Results Seven days after IVIg treatment,the average clinical absolute score of the MG patients decreased comparing with that before IVIg treatment[(17.21±10.52)vs.(23.22±10.45);n=58].The total effective rates of IVIg treatment was 48.28%(n=58)after 7 days and 59.46%(n=37)after 14 days,respectively.There was no statistical significant difference in IVIg efficacy among patients with different age,disease course,dysarthria,masticatory disorder or dyspnea.None of the patients had severe adverse reaction.Conclusions IVIg is highly effective and has a rapid response,and is safe in the treatment of myasthenia gravis patients with Osserman typeⅡb and above.

关 键 词：重症肌无力 免疫球蛋白 疗效比较研究 许氏评分 

分 类 号：R746.1[医药卫生—神经病学与精神病学]