甲泼尼龙冲击治疗急性脱髓鞘脑病的临床研究

Effect of High-Dose Methylprednisolone Pulse Therapy on Acute Demyelinating Encephalopathy

目的观察甲泼尼龙冲击治疗急性脱髓鞘脑病的疗效。方法54例患者分成观察组(30例)和对照组(24例),观察组以甲泼尼龙1000 mg/d静脉滴注3～5 d,冲击治疗结束后,予泼尼松60 mg,1次/d,逐渐减量至停药;对照组给予常规剂量地塞米松20～40 mg/d,3～5 d后逐渐减量致停药。结果观察组和对照组的总有效率分别为90.0%和66.7%,两组间差异有统计学意义(!2=3.871,P<0.05);不良反应发生率分别为13.3%和33.3%,两组间差异有统计学意义(!2=3.749,P<0.05)。结论大剂量甲泼尼龙冲击疗法是治疗急性脱髓鞘脑病较安全有效的方法。

Objective To investigate the clinical effect of high-dose methylprednisolone pulse therapy on acute demyelinating encephalopathy. Method 54 patients were divided into 2 groups： treatment group （30 patients） and control group （24 patients）. Patients in the treatment group received intravenous drop infusion with methylprednisolone （1000 mg/d） for 3 to 5 days. After the treatment, patients were then provided with dehydrocortisone （60 mg/d） for 1 day, and the dosage was gradually reduced until discontinuation. Control subjects were treated with normal dose of dehydrocortisone （20-40 mg/d） for 3 to 5 days, and the dosage was gradually reduced until discontinuation. Result The percentage efficacy in the treatment group （90%） was significantly higher than the control group （66.7%,X^2=3.871, P〈0.05）. The percentage of patients with adverse effect in the treatment group （13.3%） was significantly lower than the control group （33.3% ,X^2=3.749,P〈0.05）. Conclusion High-dose of methylprednisolone pulse therapy is safe and effective for the treatment of acute demyelinating encephalopathy.