泼尼松联合甲氨蝶呤治疗多发性肌炎及皮肌炎的临床效果观察

Clinical Observation of Polymyositis and Dermatomyositis Treated with Prednisone and Methotrexate

目的探讨泼尼松联合甲氨蝶呤治疗多发性肌炎(PM)及皮肌炎(DM)的临床疗效。方法采用泼尼松1 mg/(kg.d)晨1次口服,甲氨蝶呤每周1次,首次5 mg,以后每周递增5 mg,直至维持量15 mg/周联合治疗,治疗期间对患者肌力及肌酶进行评估和监测。治疗3个月后,判定疗效。结果肌力改善幅度达3级或3级以上者34例(94.4%),其中6例(16.7%)肌力完全恢复正常。肌酶CK,AST和LDH比治疗前均有显著下降(P<0.01)。结论泼尼松和甲氨蝶呤联合治疗对PM及DM肌酶下降和肌力改善均有较好近期效果。

Objective To discuss the therapeutic effect of prednisone plus methotrexate （MTX） on polymyositis （PM） and dermatomyositis （DM）. Methods Prednisone （ 1 mg/kg·d） and MTX were jointly applied to PM and DM, and muscular force and enzymes were examined during treatment. MTX was orally taken once per week, and its initial dose was 5 mg for the first time and then gradually up to 15 mg per week as a maintenance dose. The effect was determined three months after the beginning of treatment. Results There were 34 patients （94.4%） whose muscular force reached grade 3 or higher, and six of them gained completely normal force. The levels of muscular enzymes （ CK, AST, LDH） declined significantly in all the patients after treatment （F 〈 0.01 ）. Conclusion Good short-term effect can be reached if prednisone and MTX are jointly applied to PM and DM.