不同方案治疗儿童眼肌型重症肌无力的疗效分析

发布时间：2018-06-16 23:56

本文选题：眼肌型重症肌无力 + 儿童　；参考：《中南大学学报(医学版)》2017年11期

【摘要】：目的:观察不同方案治疗儿童眼肌型重症肌无力(myasthenia gravis,MG)的效果、复发影响因素及向全身型MG转化的转化率。方法:对2010年6月至2014年3月于中南大学湘雅医院小儿神经专科就诊的104例儿童眼肌型MG患者进行回顾性临床研究。按治疗方案分为甲基强的松龙组(n=44)、强的松组(n=48)和单用溴吡斯的明组(n=12)。采用美国MG基金会干预后状态评价系统评价治疗有效率、向全身型MG转化的转化率。结果:甲基强的松龙组较强的松组短期内的治疗有效率提高,这两组患者的有效率均高于单用溴吡斯的明组(均P0.05)。联合使用甲基强的松龙、强的松和溴吡斯的明治疗儿童眼肌型MG的远期疗效较好。早期糖皮质激素治疗可有效减少复发。结论:大剂量甲基强的松龙冲击治疗对于眼肌型MG患儿早期症状缓解起积极作用,而不同方案的糖皮质激素治疗远期疗效相似,起病年龄大、感染、甲状腺功能异常的儿童眼肌型MG患者复发率较高。
[Abstract]:Objective: to observe the effect of different regimens on myasthenia gravis MGs in children with ocular myasthenia gravis, the factors affecting recurrence and the transformation rate to systemic MG. Methods: from June 2010 to March 2014, 104 children with ocular myometric MG who were admitted to Xiangya Hospital of Central South University for pediatric neurology were studied retrospectively. The patients were divided into two groups: methylprednisolone group (n = 44), prednisone group (n = 48) and brompimide group (n = 12). The effective rate of treatment and the transformation rate to systemic MG were evaluated by the state evaluation system after intervention by the MG Foundation of USA. Results: the effective rate of methylprednisolone group was higher than that of prednisone group in a short period of time. Combined use of methylprednisolone, prednisone and brompiridamine in the treatment of myometric MG in children had good long-term results. Early glucocorticoid therapy can effectively reduce recurrence. Conclusion: high dose methylprednisolone pulse therapy plays a positive role in relieving the early symptoms of myometric MG children, while the long-term effect of glucocorticoid therapy with different regimens is similar, the onset age of the disease is older and the infection occurs. The recurrence rate of myometric MG in children with abnormal thyroid function was higher.
【作者单位】：中南大学湘雅医院儿科;
【基金】：湖南省自然科学基金(13JJ4024)~~
【分类号】：R746.1

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