大剂量甲基泼尼松龙冲击疗法治疗视神经脊髓炎21例

The treatment about cases of Neuromyelitis eptica with higher doseof methy lprednisolone

目的观察大剂量甲基泼尼松龙冲击治疗视神经脊髓炎（NMO）急性发作病例的临床疗效。方法对21例临床确诊为NMO急性发作的患者以甲基泼尼松龙1000mg／d，静脉滴注3d；随后以甲基泼尼松龙一日80mg，静脉滴注3d；随后改用泼尼松片剂口服，在一个月内逐渐减量直至停药。采用Barthel指数对入院第3天和治疗后第15天的日常生活能力进行评价，采用近视力表对治疗前后的视力进行比较。结果21例患者经治疗后，17例疗效显著，占80．9％；4例无效。人院第3天与治疗后第15天的Barthel指数总评分相比有显著差异。所有病例治疗后视力显著改善。结论大剂量甲基泼尼松龙冲击疗法对NMO急性发作治疗有效。

Objective To evaluate the clinic efficacy of the therapy with higher dose of Methylprednisolone on patients in advanced stage with neuromyelitis optica（NMO）. Methods 21 patients in advanced stage with NMO diagnosed clinically were included. Methylprednisolone was given at a dose of 1000 mg per day through intravenous drip for the first three days,followed at a dose of 80 mg per day through intravenous drip for the second three days. On the seventh day tablet Methylprednisolone was administrated and the dose was decreased gradually till stopped during one month. Routine life capacity of the patients were evaluated with Barthel index both on the third day after hospitalization and on the fifteenth day after treatment, visual capacity was compared between pre-and post-therapeutically on the same time. Results The 21 patients, 17 eases showed significant efficacy and 4 eases showed no efficacy. Grass evaluating scores of Barthel index of therapeutic effect were differed significantly between the third day after hospitalization and the fifteenth day after treatment. The visual capacity of all patients were improved markedly after treatment. Conclusion The therapy with higher dose of Methylprednisolone on patients in advanced stage with NMO is effective.