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大劑量甲潑尼龍沖擊療法治療視神經脊髓炎的療效觀察

注意:本論文已在《世界臨床藥物》2003年03期 2003 Vol.24 No.3 P.141-144發表
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賀斌 邵福源
第二軍醫大學附屬長征醫院神經內科,上海,200003

摘要:目的:觀察大劑量甲基強地松龍沖擊治療NMO急性發作病人的臨床療效。方法:對21例臨床確診為NMO急性發作的病人應用甲基強的松龍1000mg,靜滴3天,然后改甲基強的松龍80 mg靜滴3天,再以強的松30 mg口服,一個月內逐漸減量至停藥。采用Barthel指數對病人入院后第3天和治療后第15天的日常生活能力進行評價,采用近視力表對病人治療前后相同時間內的視力進行比較。結果:21例病人經過大劑量甲基強的松龍沖擊治療后,其中17例病人療效顯著,占80.9%,其日常生活能力得到明顯改善; 4例病人治療無效。病人入院第3天的Barthel 指數總評分與治療第15天的總評分相比有顯著差別。21例病人治療后的視力與治療前相比有顯著的改善。結論:大劑量甲基強的松龍沖擊療法對NMO病人的急性發作治療有效。
關鍵詞: 視神經脊髓炎; 甲基強地松龍; Barthel 指數評分

High-dose methylprednisolone in the treatment of patients with neuromyelitis optica: a clinical trial

He bin, Shao-fu yuan.
Department of neurology, Changzheng hospital, Second Military Medical University, Shanghai, China. 200003,


Abstract :
Objective: To observe the clinical effects of high-dose methylprednisolone in the treatment of the acute attacks of neuromyelitis optica(NMO). Method: 21 clinically confirmed NMO patients with acute attacks were treated with high-dose methylprednisolone , 1000mg, intravenously, once a day, for 3 consecutive days. Then, methylprednisolone , 80mg, was used intravenously, one time per day, for another 3 days. Finally, prednisolone, 30mg, was administered orally to the patients everyday and grdually withdrawn within a month. Barthel index score was employed to evaluate the activities of daily life of the patients in the 3rd day after admission and in the 15th day after the drug treatment. The near visual acuity was checked to contrast the visual loss of the patients before the drug therapy with that after the therapy. Result: 80.9%(17/21) percent of patients were responsive excellently to the high-dose methylprednisolone therapy, whose activities of daily life scores improved remarkablely. 4 patients showed no response to the therapy. The Barthel index scores of patients in the 15th day after the drug therapy had more significant improvement than those in the 3rd day before the therapy. The visual acuity of the patients increased more significantly after the drug therapy than that before the therapy. Conclusion: The high-dose methylprednisolone therapy was effective to the acute attack of the patients with NMO.
Key word: neuromyelitis optica; methylprednisolone; Barthel index score

作者簡介:賀斌:臨床碩士研究生,主治醫生,對中樞神經系統炎癥、睡眠障礙、腦血籩病等有所研究.曾獲"首屆長征新星獎",第二軍醫大學"A"級優秀教員稱號.
 

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