首页> 中文期刊> 《临床和实验医学杂志》 >丙种球蛋白联用泼尼松治疗重症肌无力临床疗效及对炎性因子的影响

丙种球蛋白联用泼尼松治疗重症肌无力临床疗效及对炎性因子的影响

         

摘要

Objective To explore the effect of prodin combined with prednisone in treatment of patients with myasthenia gravis (MG)and their effect on levels of inflammatory factors. Methods A retrospective analysis on the clinical data of 112 patients with MG treated in this hospital in March 2013 to February 2017 in Kashi area of Xinjiang Uygur Autonomous Region were randomly divided into two groups according to random-ized parellel grouping,each group with 56 cases. Patients in control group received the treatment of prednisone acetate tablets,at dosage of 1. 5 mg/ kg/ d for 1 ~ 2 months,then according to the condition of every half month or 1 month reduced 1 time,each time with reduction of 2. 5 ~ 5. 0 mg,until reduce to the minimum effective dosage;and patients in control group were treated on the basis of observation group received intravenous infusion of human immunoglobulin,at dosage of 0. 4 g/ (kg·d),beginning when administered by infusion at the rate of 40 ml/ h,then for every 30 min 10 ~ 15 ml increased rate for intravenous drip,the highest drop speed can be up to 100 ml/ h for 5 d as a treatment course. Patients in these two groups were treated with 8 consecutive treatment courses,and the clinical efficacy and changes of inflammatory factors in these two groups. were compared. Results The total effective rate in patients of observation group was 94. 6%,it was higher than 78. 6% of the control group (P <0. 05). After treatment,the levels of C3 and IgG were lower than those of control group (P < 0. 05). The levels of IL - 2,IL - 6 and TNF - αwere lower than those of control group (P < 0. 05). No serious adverse drug reaction occurred during the treatment course of these two groups. Conclusion The clinical efficacy of prednisone in treatment of patients with myasthenia gravis can be effectively improved,and blood levels of IgG,C3 and inflammatory factors can be reduced,hence this drug is safe and reliable.%目的 探讨丙种球蛋白联用泼尼松治疗重症肌无力(MG)的临床疗效及对炎性因子的影响.方法 回顾性分析2013年3月至2017年2月新疆维吾尔自治区喀什地区第二人民医院收治的112例MG患者的临床资料,按照治疗方法不同分为两组,每组各56例,对照组给予醋酸泼尼松片治疗,剂量为1.5 mg/(kg·d),治疗1~2个月,再根据病情每间隔半个月或1个月时减量1次,每次减量2.5~5.0 mg,直至降到最低有效维持剂量为止;观察组在此基础上给予静脉滴注人免疫球蛋白,剂量为0.4 g/(kg·d),开始给药时,以40 ml/h的滴速进行滴注,随后再以每间隔30 min增加10~15 ml的速度进行静脉滴注,最高滴速可至100 ml/h,连续治疗5 d为一个治疗周期.两组患者均连续治疗8个周期,对比两组患者的临床疗效、炎性因子变化.结果 观察组总有效率为94.6%,高于对照组的78.6%(P<0.05).观察组治疗后的C3、IgG水平低于对照组(P<0.05).观察组治疗后的外周血IL-2、IL-6及TNF-α 水平低于对照组(P<0.05).两组患者治疗均较安全,未见明显不良反应.结论 丙种球蛋白联用泼尼松治疗MG的临床疗效确切,可有效改善病情,并可减少IgG、C3及炎性因子,且用药安全可靠.

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