糖皮质激素联合环磷酰胺治疗重症肌无力的效果
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摘要
目的评价重症肌无力应用糖皮质激素联合环磷酰胺治疗的效果。方法选取2016年2月～2018年2月我院收治的120例重症肌无力患者作为研究对象,根据计算机随机分组法,将患者分为对照组、实验组,每组各60例。对照组患者采用糖皮质激素治疗,实验组患者采用糖皮质激素联合环磷酰胺治疗。分析两组患者的呼吸功能、血清指标、临床症状评分、临床治疗效果及不良反应发生情况。结果实验组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05);实验组患者的临床症状评分低于对照组,差异有统计学意义(P<0.05);实验组患者的呼吸肌耐力、肺活量、最大通气量高于对照组,而肌无力水平低于对照组,差异有统计学意义(P<0.05);治疗后,实验组患者的白介素-18(IL-18)水平低于对照组,而转移生长因子-β1(TGF-β1)水平高于对照组,差异有统计学意义(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论重症肌无力应用糖皮质激素联合环磷酰胺进行治疗,既可改善患者的呼吸功能、血清指标,又可缓解临床症状及体征,用药安全性较高,值得推广。
Objective To evaluate the efficacy of Glucocorticoid combined with Cyclophosphamide in the treatment of myasthenia gravis. Methods A total of 120 patients with myasthenia gravis treated in our hospital from February 2016 to February 2018 were selected as subjects. According to the computer randomization method, the patients were divided into control group and experimental group, 60 cases in each group. The control group was treated with Glucocorticoids.The experimental group was treated with Glucocorticoid combined with Cyclophosphamide. The respiratory function,serum indicators, clinical symptom score, clinical treatment effect and adverse reactions of the two groups were analyzed. Results The total effective rate of the experimental group was higher than that of the control group, the difference was statistically significant(P<0.05). The clinical symptom scores of the experimental group were lower than those of the control group, the differences were statistically significant(P<0.05). The respiratory muscle endurance, vital capacity and maximum ventilation of the experimental group were higher than those in the control group, but the myasthenic level was lower than that in the control group, the differences were statistically significant(P<0.05). The interleukin-18(IL-18) level in the experimental group was lower than that in the control group, and the transforming growth factor-β1(TGF-β1) level was higher than that in the control group, the differences were statistically significant(P<0.05). The difference in total incidence of adverse reactions was not statistically significant between the two groups(P>0.05). Conclusion Glucocorticoid combined with Cyclophosphamide in the treatment of myasthenia gravis can not only improve the patient′s respiratory function and serum indicators, but also relieve the clinical symptoms and signs with high safety, thus is worthy to be promoted.
Objective To evaluate the efficacy of Glucocorticoid combined with Cyclophosphamide in the treatment of myasthenia gravis. Methods A total of 120 patients with myasthenia gravis treated in our hospital from February 2016 to February 2018 were selected as subjects. According to the computer randomization method, the patients were divided into control group and experimental group, 60 cases in each group. The control group was treated with Glucocorticoids.The experimental group was treated with Glucocorticoid combined with Cyclophosphamide. The respiratory function,serum indicators, clinical symptom score, clinical treatment effect and adverse reactions of the two groups were analyzed. Results The total effective rate of the experimental group was higher than that of the control group, the difference was statistically significant(P<0.05). The clinical symptom scores of the experimental group were lower than those of the control group, the differences were statistically significant(P<0.05). The respiratory muscle endurance, vital capacity and maximum ventilation of the experimental group were higher than those in the control group, but the myasthenic level was lower than that in the control group, the differences were statistically significant(P<0.05). The interleukin-18(IL-18) level in the experimental group was lower than that in the control group, and the transforming growth factor-β1(TGF-β1) level was higher than that in the control group, the differences were statistically significant(P<0.05). The difference in total incidence of adverse reactions was not statistically significant between the two groups(P>0.05). Conclusion Glucocorticoid combined with Cyclophosphamide in the treatment of myasthenia gravis can not only improve the patient′s respiratory function and serum indicators, but also relieve the clinical symptoms and signs with high safety, thus is worthy to be promoted.
引文
[1]赵辉.糖皮质激素联合环磷酰胺治疗重症肌无力的疗效及安全性[J].临床研究,2018,26(6):98-99.
[2]赵微.环磷酰胺对重症肌无力伴胸腺瘤患者的治疗效果[J].中国实用医药,2018,13(1):133-134.
[3]韩秀娟,李培圣.探讨环磷酰胺和硫唑嘌呤对耐受糖皮质激素重症肌无力的疗效[J].数理医药学杂志,2017,30(3):395-396.
[4]温慧军.糖皮质激素对重症肌无力患者血清肿瘤坏死因子及白介素-6水平的影响[J].卒中与神经疾病,2017,24(4):332-334.
[5]张茵多.针灸配合糖皮质激素对重症肌无力患者免疫球蛋白及补体的作用探讨[J].中国实用医药,2017,12(6):105-107.
[6]宋丽芳.糖皮质激素治疗对重症肌无力患儿Th1/Treg细胞转录及相关因子表达的影响[J].包头医学院学报,2017,33(4):61-63.
[7]乞国艳,刘朝英,张晓静,等.多西他赛联合顺铂与大量糖皮质激素冲击治疗复发胸腺瘤合并重症肌无力的疗效比较[J].中国医院药学杂志,2017,37(16):1617-1621.
[8]宋丽.环磷酰胺联合糖皮质激素治疗IgA肾病的临床研究[J].心理医生,2017,23(26):96-97.
[9]黄华生,韦礼华,韦仕荣,等.硫唑嘌呤对耐受糖皮质激素重症肌无力的疗效分析[J].医药前沿,2016,6(22):79-80.
[10]周夕湲,赵蓓,陈学军,等.环磷酰胺联合糖皮质激素治疗重症免疫性大疱病临床观察[J].四川医学,2017,38(4):405-408.
[11]俞珊珊.大剂量糖皮质激素冲击后联合短程激素综合治疗重症肌无力的疗效观察[J].中国基层医药,2016,23(10):1549-1552.
[12]乞国艳,刘朝英,张晓静,等.多西他赛联合顺铂与大量糖皮质激素冲击治疗复发胸腺瘤合并重症肌无力的疗效比较[J].中国医院药学杂志,2017,37(16):1617-1621.
[13]张晓琳,陈炯华,王永生.环磷酰胺治疗伴胸腺瘤的重症肌无力研究进展[J].国际神经病学神经外科学杂志,2015,42(1):70-73.
[14]黄玲,王磊,尹世敏,等.环磷酰胺治疗伴胸腺瘤的重症肌无力临床研究[J].中国现代神经疾病杂志,2014,14(10):878-882.
[15]王芳.静脉注射免疫球蛋白联合利妥昔单抗治疗重症肌无力危象的近远期疗效研究[J].中西医结合心脑血管病杂志,2017,15(21):2782-2785.
[2]赵微.环磷酰胺对重症肌无力伴胸腺瘤患者的治疗效果[J].中国实用医药,2018,13(1):133-134.
[3]韩秀娟,李培圣.探讨环磷酰胺和硫唑嘌呤对耐受糖皮质激素重症肌无力的疗效[J].数理医药学杂志,2017,30(3):395-396.
[4]温慧军.糖皮质激素对重症肌无力患者血清肿瘤坏死因子及白介素-6水平的影响[J].卒中与神经疾病,2017,24(4):332-334.
[5]张茵多.针灸配合糖皮质激素对重症肌无力患者免疫球蛋白及补体的作用探讨[J].中国实用医药,2017,12(6):105-107.
[6]宋丽芳.糖皮质激素治疗对重症肌无力患儿Th1/Treg细胞转录及相关因子表达的影响[J].包头医学院学报,2017,33(4):61-63.
[7]乞国艳,刘朝英,张晓静,等.多西他赛联合顺铂与大量糖皮质激素冲击治疗复发胸腺瘤合并重症肌无力的疗效比较[J].中国医院药学杂志,2017,37(16):1617-1621.
[8]宋丽.环磷酰胺联合糖皮质激素治疗IgA肾病的临床研究[J].心理医生,2017,23(26):96-97.
[9]黄华生,韦礼华,韦仕荣,等.硫唑嘌呤对耐受糖皮质激素重症肌无力的疗效分析[J].医药前沿,2016,6(22):79-80.
[10]周夕湲,赵蓓,陈学军,等.环磷酰胺联合糖皮质激素治疗重症免疫性大疱病临床观察[J].四川医学,2017,38(4):405-408.
[11]俞珊珊.大剂量糖皮质激素冲击后联合短程激素综合治疗重症肌无力的疗效观察[J].中国基层医药,2016,23(10):1549-1552.
[12]乞国艳,刘朝英,张晓静,等.多西他赛联合顺铂与大量糖皮质激素冲击治疗复发胸腺瘤合并重症肌无力的疗效比较[J].中国医院药学杂志,2017,37(16):1617-1621.
[13]张晓琳,陈炯华,王永生.环磷酰胺治疗伴胸腺瘤的重症肌无力研究进展[J].国际神经病学神经外科学杂志,2015,42(1):70-73.
[14]黄玲,王磊,尹世敏,等.环磷酰胺治疗伴胸腺瘤的重症肌无力临床研究[J].中国现代神经疾病杂志,2014,14(10):878-882.
[15]王芳.静脉注射免疫球蛋白联合利妥昔单抗治疗重症肌无力危象的近远期疗效研究[J].中西医结合心脑血管病杂志,2017,15(21):2782-2785.