糖皮质激素联合环磷酰胺治疗重症肌无力的效果

Effect of Glucocorticoid combined with Cyclophosphamide on myasthenia gravis

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.