糖皮质激素在神经系统疾病中的规范化应用  

Guideline-recommended application of glucocorticoid in neurological disorders

作　　者：刘梦 吴思缈[1] LIU Meng;WU Simiao(Department of Neurology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院神经内科,成都610041

出　　处：《华西医学》2022年第12期1891-1898,共8页West China Medical Journal

基　　金：国家自然科学基金(82171285);四川省科学技术厅应用基础研究项目(2021YJ0433);四川大学华西医院学科发展1·3·5工程项目(ZYGD18009)。

摘　　要：糖皮质激素是多种神经系统疾病的一线治疗药物。根据神经系统疾病的种类和特点,糖皮质激素的用法不同。该文回顾了近10年国内外神经系统疾病糖皮质激素治疗诊疗指南和专家共识,总结了我国最新指南和共识的推荐方案。总体上,我国神经系统疾病激素冲击治疗最常用方案为大剂量(一般1000 mg/d)甲泼尼龙短疗程(不超过5 d)静脉滴注,冲击后可阶梯递减、桥接口服泼尼松缓慢减量或直接停药。儿童和青少年激素治疗方案与成人类似,但激素剂量多按体重计算,围产期女性用药应注意其药理代谢特点。临床医生应根据各神经疾病及患者个体特点,掌握糖皮质激素的规范化应用方案。Glucocorticoids are the first-line therapy of many neurological disorders,with the treatment regimen varying across types and characteristics of neurological disorders.This article reviews the national and international guidelines and expert consensuses in the past decade on glucocorticoids treatment for neurological disorders,and summarizes recommendations from the latest Chinese guidelines and consensuses.In summary,the most frequently used pulse therapy of glucocorticoids in China is intravenous infusion of high-dose(usually 1000 mg/d)methylprednisolone in a short period(often<5 d),followed by gradual tapering,bridging with oral prednisone or direct discontinuation.The treatment regimen for children and juveniles is similar to that for adults but the dose is adjusted by body weight.Pharmacodynamics of glucocorticoids should be considered for the treatment of perinatal women.To provide appropriate glucocorticoids treatment for patients with neurological disorders,clinicians should fully understand features of each neurological disorder and clinical characteristics of individual patient.

关 键 词：糖皮质激素 神经系统疾病 规范化临床应用 指南 

分 类 号：R741[医药卫生—神经病学与精神病学]