大剂量甲基泼尼松龙冲击联合神经节苷脂治疗对急性脊髓炎患者炎症反应、免疫平衡的影响  

Effect of High-dose Methylprednisolone Pulse Therapy Combined with Ganglioside on Inflammatory Response and Immune Balance in Patients with Acute Myelitis

作　　者：李含阳 张玉 于莹 LI Han-yang;ZHANG Yu;YU Ying(Department of Pharmacy,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯市中心医院药剂科,黑龙江佳木斯154002

出　　处：《医学信息》2023年第8期135-138,共4页Journal of Medical Information

摘　　要：目的研究大剂量甲基泼尼松龙冲击联合神经节苷脂治疗对急性脊髓炎患者炎症反应、免疫平衡的影响。方法选取2021年6月1日-2022年6月1日我院诊治的86例急性脊髓炎患者为研究对象,采用随机数字表法分为对照组(n=43)和观察组(n=43)。对照组采用大剂量甲基泼尼松龙冲击治疗,观察组在对照组基础上联合神经节苷脂治疗,比较两组临床疗效、神经功能(自主行走、肌力恢复2级以上、排尿)恢复时间、炎症因子水平[C反应蛋白(CRP)、白细胞介素-6(IL-6)]、免疫功能指标(CD3^(+)CD8^(+)IL-17ATh17、CD3^(+)CD4^(+)+CD25^(+)+Treg)、不良反应发生率。结果观察组治疗总有效率为95.35%,高于对照组的79.07%(P<0.05);观察组自主行走、肌力恢复2级以上、排尿恢复时间均短于对照组(P<0.05);两组治疗后CRP、IL-6水平低于治疗前,且观察组低于对照组(P<0.05);两组治疗后CD3^(+)CD8^(+)IL-17ATh17低于治疗前,CD3^(+)CD4^(+)+CD25^(+)+Treg高于治疗前,且观察组CD3^(+)CD8^(+)IL-17ATh17低于对照组,CD3^(+)CD4^(+)+CD25^(+)+Treg高于对照组(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论大剂量甲基泼尼松龙冲击联合神经节苷脂可提高急性脊髓炎治疗疗效,抑制炎性反应,改善免疫平衡,缩短神经功能恢复时间,且不增加不良反应发生风险,安全性较高。Objective To study the effect of high-dose methylprednisolone pulse combined with ganglioside on inflammatory response and immune balance in patients with acute myelitis.Methods A total of 86 patients with acute myelitis diagnosed and treated in our hospital from June 1,2021 to June 1,2022 were selected as the research objects.They were divided into control group(n=43)and observation group(n=43)by random number table method.The control group was treated with high-dose methylprednisolone pulse therapy,and the observation group was treated with ganglioside on the basis of the control group.The clinical efficacy,recovery time of neurological function(autonomous walking,muscle strength recovery above grade 2,urination),inflammatory factor levels[C-reactive protein(CRP),interleukin-6(IL-6)],immune function indicators(CD3^(+)CD8^(+)IL-17ATh17,CD3^(+)CD4^(+)+CD25^(+)+Treg),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 95.35%,which was higher than 79.07% in the control group(P<0.05).The time of independent walking,muscle strength recovery above grade 2 and urination recovery in the observation group were shorter than those in the control group(P<0.05).After treatment,the levels of CRP and IL-6 in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).After treatment,CD3^(+)CD8^(+)IL-17ATh17 in the two groups was lower than that before treatment,CD3^(+)CD4^(+)+CD25^(+)+Treg was higher than that before treatment,and CD3^(+)CD8^(+)IL-17ATh17 in the observation group was lower than that in the control group,CD3^(+)CD4^(+)+CD25^(+)+Treg was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion High-dose methylprednisolone pulse combined with ganglioside can improve the therapeutic effect of acute myelitis,inh

关 键 词：甲基泼尼松龙 神经节苷脂 急性脊髓炎 免疫平衡 

分 类 号：R744.3[医药卫生—神经病学与精神病学]