糖皮质激素与环磷酰胺联合治疗脑动脉炎的临床效果观察  

Clinical effect of glucocorticoid combined with cyclophosphamide in the treatment of cerebral arteritis

作　　者：赵婧 丁茹茹 李娜 Zhao Jing;Ding Ruru;Li Na(Department of Neurology,Henan General Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南省职工医院神经内科,河南郑州450003

出　　处：《感染、炎症、修复》2024年第4期279-282,共4页Infection Inflammation Repair

摘　　要：目的:探讨糖皮质激素与环磷酰胺联合治疗脑动脉炎患者对炎症指标变化与神经功能恢复的影响。方法:回顾性分析93例脑动脉炎患者的临床资料。患者为2020年3月至2022年6月河南省职工医院收治,采用随机数字表法分为对照组(予以甲泼尼龙琥珀酸钠,n=46)与观察组(予以甲泼尼龙琥珀酸钠+环磷酰胺,n=47)。对比两组临床疗效、炎性因子水平[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、神经恢复情况[美国国立卫生研究院卒中量表(NIHSS)与运动功能评分量表(FMA)评分]、不良反应发生情况及复发率。结果:总有效率,观察组为95.74%,对照组为80.43%,观察组高于对照组(P<0.05);不良反应发生率,观察组为14.89%,对照组为32.60%;观察组低于对照组(P<0.05)。治疗4个疗程后,相较于对照组,观察组IL-6、TNF-α、CRP水平及NIHSS评分更低,FMA评分更高(P<0.01);两组各个时间点复发率比较无显著差异(P>0.05)。结论:糖皮质激素联合环磷酰胺可有效提高脑动脉炎患者的临床疗效,显著改善炎症反应、神经功能,且安全性佳。Objective:To explore the effects of combined treatment of glucocorticoids and cyclophosphamide on the changes in inflammatory indexes and neurological function recovery in patients with cerebral arteritis.Methods:An analysis was performed on 93 patients with cerebral arteritis admitted to Henan General Hospital from March 2020 to June 2022.They were divided into the control group(given methylprednisolone sodium succinate,n=46)and the observation group(given methylprednisolone sodium succinate+cyclophosphamide,n=47)by random number method.The clinical efficacy,levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],neurological recovery[National Institutes of Health Stroke Scale(NIHSS)]and Fugl-Meyer motor function assessment(FMA)scores],adverse reactions and recurrence rate were compared between the two groups.Results:The total effective rate and incidence of adverse reactions were 95.74%and 14.89%in the observation group,and 80.43%and 32.60%in the control group,respectively.Compared with the control group,the total effective rate in the observation group was higher and the incidence of adverse reactions was lower(P<0.05).After 4 courses of treatment,compared with control group,the levels of IL-6,TNF-α,CRP and NIHSS in the observation group were lower,and the FMA score was higher(P<0.01).There was no difference in recurrence rate between the two groups at each time point(P>0.05).Conclusions:Glucocorticoid combined with cyclophosphamide can effectively improve the clinical efficacy of patients with cerebral arteritis,significantly improve the inflammatory response and neurological function,and has good safety.

关 键 词：脑动脉炎 糖皮质激素 环磷酰胺 炎症指标 神经功能 

分 类 号：R543.5[医药卫生—心血管疾病]