静脉注射免疫球蛋白联合利妥昔单抗治疗重症肌无力危象患者的近远期效果

Short-term and Long-term Effects of Intravenous Immunoglobulin Combined with Rituximab in the Treatment of Patients with Myasthenia Gravis

目的探讨重症肌无力(MG)危象患者采用静脉注射免疫球蛋白(IVIG)联合利妥昔单抗(RTX)治疗的近远期效果。方法选取2016年1月至2018年2月沈阳市第一人民医院神经内科收治的MG危象患者34例患者作为研究对象,随机分为观察组与对照组,各17例。对照组采用IVIG治疗,观察组采用IVIG联合RTX治疗,比较两组患者的治疗效果。结果治疗180 d后,观察组血清IgM、IgG、IeE、IgA水平低于对照组,差异有统计学意义(P<0.05);治疗180d后,观察组血清人抗兰尼碱受体钙释放通道抗体(RyR-Ab)、抗乙酰胆碱受体抗体(AchR-Ab)、肌联蛋白抗体(Titin-Ab)水平低于对照组,差异有统计学意义(P<0.05);治疗180 d后,观察组肌无力改善状态绝对评分低于对照组,差异有统计学意义(P<0.05)。结论 IVIG联合RTX治疗MG危象患者疗效持久,效果显著,可有效改善患者临床症状。

Objective To explore the short-term and long-term effects of intravenous immunoglobulin(IVIG) combined with rituximab(RTX) in the treatment of myasthenia gravis(MG). Methods A total of 34 patients with Mg crisis from January 2016 to February 2018 were selected as the research objects and were randomly assigned into an observation group and a control group, with 17 cases in each group. The control group was treated with IVIG. The observation group was treated with IVIG combined with RTX. The therapeutic effect of the 2 groups was compared. Results After 180 days of treatment, the levels of serum IgM, IgG, IeE, IgA in the observation group were lower than those in the control group, the difference was statistically significant(P<0.05). Conclusion IVIG combined with RTX is a long-term and effective for the treatment of MG patients, which can effectively improve the clinical symptoms.