硫唑嘌呤或环孢素A联合糖皮质激素治疗重症肌无力的疗效比较  

Curative effect of azathioprine and cyclosporine A respectively combined with glucocorticoids in the treatment of myasthenia gravis:a comparative study

作　　者：邓琳[1] 文贵斌[1] DENG Lin;WEN Gui-bin(Department of Neurology,Zigong Fourth People's Hospital,Zigong 643000,Sichuan,China)

机构地区：[1]自贡市第四人民医院神经内科,四川自贡643000

出　　处：《川北医学院学报》2022年第3期362-365,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨硫唑嘌呤(AZA)或环孢素A(CyA)联合糖皮质激素(GC)治疗重症肌无力(MG)的疗效。方法:选取90例MG患者为研究对象,依据治疗方式不同分为对照组和观察组,每组各45例。对照组采用AZA+GC治疗;观察组采用CyA+GC治疗,疗程均为两年。比较两组患者治疗前与治疗1年后重症肌无力定量评分(QMGS评分)、重症肌无力复合量表(MGC评分)、肌无力肌肉量表(MMS评分)、抗乙酰胆碱受体抗体(AchR-Ab)、免疫球蛋白E(IgE)、白细胞介素-6(IL-6)水平及总疗效率、药物毒性反应与复发情况。结果:治疗1年后,两组患者QMGS、MGC、MMS得分明显减少且血清AchR-Ab、IgE、IL-6水平均较治疗前降低(P<0.05),组间比较差异无统计学意义(P>0.05)。两组患者治疗的总疗效率、药物毒性总发生率与复发率比较,差异无统计学意义(P>0.05)。结论:AZA或CyA联合GC治疗MG的疗效相当,均能有效调节自身异常免疫反应,恢复肌肉正常功能,且有较高的安全性。Objective:To compare the effect of azathioprine(AZA)and cyclosporine A(CyA)respectively combined with glucocorticoids(GC)in the treatment of myasthenia gravis(MG).Methods:90 patients with MG were selected as the research objects.They were divided into control group and observation group according to different treatment methods,with 45 cases in each group.The control group was treated with AZA+GC,and the observation group was treated with CyA+GC,the course of treatment was 2 years.The scores of Quantitative Myasthenia Gravis Score(QMGS),Myasthenia Gravis Composite(MGC),Myasthenic Muscle Scale(MMS)and the levels of anti-acetylcholine receptor antibody(AchR-Ab),immunityglobulin E(IgE),interleukin-6(IL-6),total therapeutic efficiency,drug toxicity and recurrence of the two groups were compared before treatment and 1 year after treatment.Results:After 1 year of treatment,the scores of QMGS,MGC,MMS and the levels of AchR-Ab,IgE,IL-6 were significantly reduced in the two groups(P<0.05),but there was no statistical difference between the two groups(P>0.05).There was no statistical difference in the total response rate,the total incidence of drug toxicity and the recurrence rate between the two groups after 1 year of treatment(P>0.05).Conclusion:AZA and CyA respectively combined with GC have similar curative effects in the treatment of MG,both of which can effectively regulate their own abnormal immune response,restore normal muscle function,and with high safety guarantees.

关 键 词：重症肌无力 糖皮质激素 硫唑嘌呤 环孢素A 

分 类 号：R746.1[医药卫生—神经病学与精神病学]