甲基强的松龙与地塞米松治疗脊髓型颈椎病临床分析

Effects of methylprednisolone vursus dexamethasone on limb and neurological functions in patients with cervical spondylotic myelopathy

目的探讨甲基强的松龙与地塞米松对脊髓型颈椎病(CSM)患者肢体、神经功能的影响。方法选取2013-07-2015-07收治的CSM患者62例,以随机数表法分为观察组和对照组,每组31例;观察组给予甲基强的松龙治疗,对照组给予地塞米松治疗,分别采用DHI(Dunz9z手部功能指数)评分、JOA脊髓功能评分评估2组患者治疗前后肢体与神经功能,并观察2组用药不良反应发生情况。结果与治疗前比较,2组治疗后左右手DHI评分均明显升高(P<0.05);与对照组比较,观察组治疗后左右手DHI评分分别为(79.33±6.17)分、(82.51±4.73)分均明显升高(P<0.05);与治疗前比较,2组治疗后1d、7d、30d、60dJOA评分均显著升高(P<0.01),与对照组比较,观察组治疗后7d、30d、60dJOA评分分别为(11.02±1.59)分、(12.03±1.67)分、(13.92±1.96)分均明显升高(P<0.05);2组均未出现明显不良反应。结论与地塞米松相比,甲基强的松龙可显著提高CSM患者DHI评分和JOA评分,对改善患者肢体、神经功能恢复有更积极的影响。

Objective To explore the effects of methylprednisolone vursus dexamethasone on limb and neurological functions in patients with cervical spondylotic myelopathy （CSM）. Methods 62 cases with CSM treated in our hospital from July 2013 to July 2015 were selected, and they were divided by random number table method into the observation group and the control group （31 cases in each group）. Cases in observation group were given methylprednisolone after the operation, cases in the control group received dexamethasone after the operation. DHI （Dunz6z hand function index） scores and JOA spinal cord function scores were used to evaluate limb and neurological functions in the two groups before and after treatment. Adverse reactions in the two groups were observed. Results Compared with those before the treatment,DHI scores of left and right hands in the two groups after the treatment were significantly increased （P〈0.05）, and after treatment the observation group in which DHI scores of left hand were （79. 33±6.17） points and scores of right hand were （82. 51±4. 73） points showed higher DHI scores than the control group （P〈0.05）. On the 1st, 7th,30th and 60th day after treatment the JOA scores in both two groups were significantly in- creased （P〈0.01） ,and in the observation group the JOA presented （11.02±1. 59） scores, （12.03±1.67） scores and （13.92±1.96） scores, respectively,which were significantly higher than those in the control group （P〈0. 05）. No adverse reactions oc- curred in two groups. Conclusion Compared with dexamethasone, methylprednisolone can significantly improve DHI scores and JOA scores in CSM patients and can have more positive effects on the improvement of limb and neurological functional recovery.