大剂量糖皮质激素冲击治疗重症肌无力的效果观察  

Effect observation of high-dose glucocorticoid pulse therapy in the treatment of myasthenia gravis

作　　者：方财林 卢立军[1] 姚尚争 Fang Cailin;Lu Lijun;Yao Shangzheng(Pharmaceutical Department,The First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 473000,China;The Third Inpatient Ward of Neurology Department,The First Affiliated Hospital of Nanyang Medical College,Nanyang Henan 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院药学部,河南南阳473000 [2]南阳医学高等专科学校第一附属医院神经内科三病区,河南南阳473000

出　　处：《保健医学研究与实践》2023年第7期40-43,共4页Health Medicine Research and Practice

摘　　要：目的探讨大剂量糖皮质激素冲击治疗在重症肌无力患者治疗中的效果,以期为临床治疗提供参考。方法本研究选取南阳医学高等专科学校第一附属医院2019年1月—2021年12月收治的92例重症肌无力患者为研究对象。采用随机数字表法将患者分为对照组与观察组,每组46例。对照组患者采用常规治疗,包括营养支持、免疫抑制剂等。观察组患者在对照组治疗基础上采用大剂量糖皮质激素冲击治疗。治疗结束时,比较2组患者治疗效果。比较2组患者治疗前后(治疗后为治疗结束时)血清乙酰胆碱受体抗体(AchR-Ab)水平。治疗结束后比较2组患者临床分型。结果2组患者治疗效果比较,差异无统计学意义(P>0.05)。治疗前,2组患者AchR-Ab水平比较,差异无统计学意义(P>0.05),治疗后,观察组患者低于治疗前,且低于对照组,差异均有统计学意义(P<0.05)。观察组患者临床分型优于对照组,差异有统计学意义(P<0.05)。结论大剂量糖皮质激素冲击疗法能有效治疗重症肌无力,可降低AchR-Ab水平,改善患者临床分型,安全有效,值得推广应用。Objective This study aimed to investigate the effect of high-dose glucocorticoid pulse therapy in the treatment of patients with myasthenia gravis to provide evidence for clinical treatment.Methods Ninety-two patients with myasthenia gravis admitted to the First Affiliated Hospital of Nanyang Medical College from January 2019 to December 2021 were selected as the study participants.They were randomly allocated to the control and observation groups,with 46 cases in each group.Patients in the control group received routine treatment,including nutritional support and immunosuppressive agents;patients in the observation group,a high-dose glucocorticoid pulse therapy based on the treatment in the control group.At the end of treatment,the treatment outcome was compared between the two groups.The acetylcholine receptor antibody(AchR-Ab)levels between the two groups before and after treatment(after treatment defined as at the end of treatment)and the clinical classification of the patients in the two groups after treatment were compared.Results There was no significant difference in the treatment outcome between the groups(P>0.05).Before treatment,no significant difference was observed in AchR-Ab level between the groups(P>0.05).After treatment,the AchR-Ab level in the observation group declined,and was lower than that in the control group,with statistical significance(P<0.05).The clinical classification of the observation group was significantly better than that of the control group(P<0.05).Conclusion Highdose glucocorticoid pulse therapy can effectively treat myasthenia gravis,reduce the level of AChR-Ab,and improve the clinical classification of patients,which serves as an effective therapy and has high safety and profiles.These benefits hold promise for a wider application of this therapy.

关 键 词：重症肌无力 大剂量糖皮质激素冲击治疗 治疗效果 

分 类 号：R746.1[医药卫生—神经病学与精神病学]