不同剂量甲基泼尼松龙在急性脊髓炎中的疗效比较

Observation on the efficacy of different doses of methylprednisolone on patients with acute myelitis

目的观察不同剂量甲基泼尼松龙治疗急性脊髓炎的疗效。方法将本院2010-06—2013-01收诊的急性脊髓炎患者随机分成2组,甲基泼尼松龙大剂量组(1 000mg/次)和小剂量组(500mg/次)各36例。治疗前后采用美国脊髓损伤学会制定的ASIA评分标准对2组患者的运动功能、触觉、痛觉进行评分,比较组间差异;对比2组患者神经功能恢复时间的差异。结果治疗5周后,大剂量组运动功能、触觉、痛觉ASIA评分均显著高于小剂量组(P<0.05)。大剂量组排尿恢复时间、肌力改善2级以上时间及下地行走时间均显著短于小剂量组(P<0.05)。结论大剂量甲基泼尼松龙(1 000mg/次)治疗急性脊髓炎能更好促进患者运动功能、触觉、痛觉和神经功能的恢复,疗效优于小剂量甲基泼尼松龙(500mg/次)。

Objective To investigate the efficacy of different doses of methylprednisolone on patients with acute myelitis. Methods Patients with acute myelitis from June 2010 to January 2013 were randomly divided into High-dose group（1000mg/ d）with 36 cases and low-dose group（500mg/d）with 36 cases,then ASIA score of normal motor function, touch, pain of the two groups of patients before the treatment and at 5th week after the treatment were compared, and the time of neurological func- tion recovery in two groups were also compared. Results At 5 weeks after treatment, the ASIA scores of normal motor func- tion, touch, pain in high-dose group were significantly higher than those in low dose group; the time of urination recovery, muscle strength improved two or more scales and ambulation in high- dose group were significantly shorter than those in lowdose group,all P〈0.05. Conclusion High- dose of methylprednisolone treatment can better promote motor function, touch, pain, and recovery of neurological function in patients with acute myelitis, and it is more effective than low-dose methylpred- nisolone