早期糖皮质激素冲击疗法对视神经脊髓炎视功能恢复的影响

摘要

目的：观察早期糖皮质激素冲击疗法对视神经脊髓炎视功能恢复的影响。方法：选取2011年10月-2014年4月在我院住院治疗的视神经脊髓炎（NMO）患者42例（50眼），随机分为观察组和对照组，各21例。观察组给予注射用甲泼尼龙，注射用地塞米松，泼尼松片口服；对照组患者给予注射用地塞米松，泼尼松片口服。结果：治疗后，观察组患者视力提高总有效率为80.77%，对照组患者为66.67%，两组比较差异具有统计学意义（P＜0.05）；治疗后，两组患者视网膜神经纤维层（RNFL）厚度均明显升高，且观察组患者明显高于对照组患者（P＜0.05）；观察组患者Barthel指数总评分明显高于对照组患者（P＜0.05）。结论：早期糖皮质激素冲击疗法治疗视神经脊髓炎，可促进患者视力和日常生活能力的恢复，疗效显著。%Objective:To discuss the effect of early glucocorticoid pulse therapy for the visual function of patients with neuromyelitis optica (NMO). Methods:Forty-two cases of patients with NMO from our hospital during October, 2011 to April, 2014 were selected and randomly divided into an observation group and a control group with 21 cases each. Patients were treated with the intravenous injection of both methylprednisolone and dexamethasone and the oral prednisone in the observation group while the intravenous injection of dexamethasone and the oral prednisone in the control group. Results:After treatment, the total efifciency was 80.77%in the observation group and 66.67%in the control group and their differences were statistically signiifcant (P<0.05). The thickness of retinal nerve ifber layer (RNFL) was all signiifcantly increased after treatment, which was signiifcantly thicker in the observation group than in the control group (P<0.05). The total scores of Barthel index were signiifcantly higher in the observation group than in the control group (P<0.05). Conclusion:Early glucocorticoid pulse therapy for patients with NMO can promote the recovery of visual acuity and daily living ability with obvious curative effect.