甲基泼尼松龙冲击治疗Balo病

Eighteen patients of Balo disease treated by methylprednisolone pulse therapy

目的观察甲基泼尼松龙冲击疗法(MPPT)治疗Balo病的近期及远期临床疗效。方法18例Balo病患者,均经过临床及头颅MRI有特异性表现所明确诊断。成人采用甲基泼尼松龙(MP)1000mg/d,儿童20mg·kg-1·d-1)加入5%葡萄糖1000ml溶液内静脉缓慢滴注,连用3d为1疗程,每月1疗程,共3个疗程。结果近期临床疗效(3个月内)为:显效12例(66.7%),有效4例(22.2%),无效2例(11.1%);临床观察6个月、1年、2年和3年时临床缓解率均为72.2%。结论MPPT治疗Balo病3个月～3年长期缓解率较高,6月内无缓解的预后差,有疗效的患者采用小剂量泼尼松龙可以取得较长的缓解时间,有一定的临床实用和推广价值。

Objective To evaluate the therapeutic effect of Balo disease treated by methylprednisolone pulse therapy （MPPT） including the followed-up of recent clinical efficacy and long-term clinical efficacy. Methods Eighteen patients of Balo disease used MPPT and were diagnosed to undergo a brain MRI and clinical performance of a specific. The adult dose used was methylprednisolone（MP） 1 000 mg/ d, and the children dose was 20mg/（kg·d） by adding 5% glucose solution with 1 000 ml slowly intravenous drip. Three days of continuous use was a course of treatment per month, a total of three treatments. Results The recent curative effect （within 3 months after treatment） was as follows： twelve eases （66.7%） acquired a significant effect, four cases （22.2%） patients＇conditions were improved, and two cases （11.1%） had no effect. The rate increased to 72.2% after retesting at 6 months, 1 year, 2 years and 3 years. Conclusion Most Balo disease patients treated with MPPT had acquired perfectly curative effect from 6 months to 3 years after treatment. However, some did not acquire a good effect in six months and became worse. The patients with therapeutic use of low-dose prednisone can have a longer remission time. This method has some clinical utility value and should be promoted as useful.