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大剂量糖皮质激素治疗早期类风湿性关节炎的不良反应 被引量:10

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摘要 目的观察大剂量糖皮质激素治疗早期活动性类风湿关节炎过程中所伴发的不良反应。方法 (1)将符合早期活动性类风湿性关节炎的33名患者随机分为"大剂量组"与"小剂量组",分别给与大、小剂量的糖皮质激素以及DMARDs、NSAIDs治疗。(2)历史对照组只给予DMARDs以及NSAIDs治疗。(3)3组患者均分别在治疗开始时,治疗后1周、1月、3月、6月、12月详细记录患者BMD、体质量、血糖、血压、胃肠道反应等糖皮质激素相关不良反应;详细记录每位患者使用NSAIDs的天数。(4)统计学方法:对BMD进行重复测量设计的方差分析;其他相关不良反应进行行×列表资料的χ2检验;对3组患者所使用NSAIDs的天数进行多个样本比较的秩和检验。结果 3组患者的BMD随时间变化的趋势差异无统计学意义(F=0.079,P=0.924)。大剂量组患者体质量增加的发生率(31.3%)高于小剂量组(23.5%)、历史对照组(4.9%),差异有统计学意义(χ2=7.833,P=0.011);大剂量组患者出现胃肠道不适的发生率(12.5%)低于小剂量组(17.6%)、历史对照组(51.2%),差异有统计学意义(χ2=10.532,P=0.005)。历史对照组使用NSAIDs的天数(平均为51.17 d)较大剂量组(平均为14.16 d)、小剂量组(平均为26.50 d)长,差异有统计学意义(χ2=39.954,P=0.000)。结论大剂量糖皮质激素的应用除了使患者的体质量短暂增加外,没有给患者带来太多的不良反应;反而因为减少了NSAIDs的使用,使患者胃肠道不适的发生率降低。
作者 刘凤芹 周毅
出处 《中国校医》 2014年第4期295-297,共3页 Chinese Journal of School Doctor
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