糖皮质激素联合胎盘多肽注射液治疗重症肌无力62例疗效观察

摘要

目的：探讨糖皮质激素(GC)联合胎盘多肽注射液治疗重症肌无力(MG)患者的疗效及安全性。方法124例MG患者被随机分为对照组和观察组，每组均为62例。对照组静脉滴注GC+甲泼尼龙+醋酸泼尼松，观察组在对照组基础上静脉注射胎盘多肽注射液。观察和比较两组临床疗效、治疗前后患者受累肌群肌无力严重程度绝对评分和相对评分、T淋巴细胞转化率、外周血免疫球蛋白和补体水平的变化以及不良反应情况。结果治疗后观察组患者受累肌群肌无力严重程度绝对评分为(10.18±4.11)分，显著低于对照组绝对评分(P<0.05)；相对积分为(60.39±14.05)%，显著低于对照组(P<0.05)；观察组治愈率、显效率和总有效率分别达到11.29%、46.77%和88.52%，显著高于对照组(P<0.05)；治疗后T淋巴细胞转化率达到(65.07±14.16)%，显著高于治疗前和对照组水平(P<0.05)；总不良反应率为14.52%，显著低于对照组(P<0.05)。结论胎盘多肽注射液可提高糖皮质激素治疗重症肌无力患者T淋巴细胞转化率，增强MG患者免疫力和抵抗力，综合疗效优于单用糖皮质激素。%Objective To investigate the curative effect and safety of glucocorticoid (GC) combined with placenta polypeptide injection in the treatment of patients with myasthenia gravis (MG). Methods One hundred and twenty-four patients with MG were randomly divided into the control group and the observation group, with 62 cases in each group. The control group received intravenous injection of GC, methylprednisolone and prednisone acetate, while the observation group received intravenous injection of placenta polypeptide based on the control group. The clinical curative effect, the absolute score and relative score of gravis severity of patients' tired muscles, transforma-tion rate of T lymphocyte, changes of peripheral blood immunoglobulin and complement levels, as well as adverse re-actions of two groups before and after treatment were observed and compared. Results The absolute scores of the ob-servation group after treatment was (10.18±4.11), significantly lower than that of the control group (P<0.05). The rela-tive score of the observation group after treatment was (60.39 ± 14.05), significantly lower than that of the control group (P<0.05). The cure rate, markedly effective rate and total effective rate of the observation group reached 11.29%, 46.77%and 88.52%respectively, significantly higher than those of the control group (P<0.05). The transfor-mation rate of T lymphocyte reached (65.07 ± 14.16)%, significantly higher than that of the control group (P<0.05). The rate of adverse reactions was 14.52%, significantly lower than the control group (P<0.05). Conclusion The pla-centa polypeptide injection could improve the transformation rate of T lymphocyte, enhance immunity and resistance of glucocorticoid in the treatment of patients with myasthenia gravis, and the comprehensive curative effect is better than single glucocorticoid.