多西他赛联合顺铂与大量糖皮质激素冲击治疗复发胸腺瘤合并重症肌无力的疗效比较

发布时间：2018-03-14 07:51

本文选题：复发胸腺瘤　切入点：重症肌无力　出处：《中国医院药学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的:比较多西他赛联合顺铂与大量糖皮质激素冲击治疗胸腺瘤切除术后胸腺瘤复发合并重症肌无力(MG)患者的临床疗效。方法:选取2013年1月-2015年1月就诊于某院的32例胸腺瘤切除术后胸腺瘤复发合并重症肌无力患者。其中,20例患者接受多西他赛联合顺铂治疗(DP组),12例患者采用大量糖皮质激素冲击治疗。对比观察2组患者治疗前后乙酰胆碱受体抗体(acetylcholine receptor antibody,AchR-Ab)和临床绝对评分(clinic definitely score,CDS)的变化,并记录化疗不良反应的发生。结果:2组患者的AchR-Ab水平及CDS分别与治疗前相比,治疗后均显著改善,差异有统计学意义(P0.05)。大量激素冲击组治疗肌无力有效率为97.7%,DP组治疗肌无力有效率为95.0%,2组患者MG治疗的疗效差异无统计学意义(P0.05)。大量激素冲击组治疗胸腺瘤显效率为75.0%,DP组治疗胸腺瘤显效率为30.0%。2组方案胸腺瘤治疗的疗效差异有统计学差异(P0.05)。大量激素冲击组患者不良反应的发生率为66.7%,而DP组为25.0%。结论:大量糖皮质激素冲击对复发胸腺瘤合并MG的肌无力和胸腺瘤两方面疗效显著,但不良反应大。多西他赛联合顺铂对复发胸腺瘤合并MG的肌无力疗效显著,同时不良反应小,但对胸腺瘤方面作用不明显。
[Abstract]:Objective: to compare the clinical efficacy of docetaxel combined with cisplatin and massive glucocorticoid in the treatment of recurrent thymoma with myasthenia gravis after thymoma resection. 32 cases of thymoma recurrence with myasthenia gravis after thymoma resection in our hospital. Among them, 20 cases were treated with docetaxel combined with cisplatin. 12 patients in DP group were treated with massive glucocorticoid shock therapy. The changes of acetylcholine receptor antibody AchR-Aband clinical absolute score before and after treatment were observed. Results the levels of AchR-Ab and CDS in the two groups were significantly improved compared with those before treatment. The difference was statistically significant (P 0.05). The effective rate of treatment of myasthenia was 97.7% in the massive hormone shock group and 97.7% in the DP group. There was no significant difference in the treatment of MG between the two groups (P 0.05). The effective rate of treatment of thymoma in the large amount of hormone shock group was 97.7%. The effective rate of treatment of thymoma in group DP was 30.0.2. There was statistical difference in the curative effect of treatment of thymoma. The incidence of adverse reactions was 66.7 in group B and 25.0 in group DP. Conclusion: a large amount of glucocorticoid impact on thymoma. The curative effects of myasthenia and thymoma in recurrent thymoma combined with MG were significant. But the adverse effects of docetaxel combined with cisplatin on myasthenia in patients with recurrent thymoma with MG were significant, and the adverse reactions were small, but the effect on thymoma was not obvious.
【作者单位】：石家庄市第一医院重症肌无力诊疗中心;
【基金】：河北省自然科学基金(编号:H2015106020) 石家庄市科技局指导项目(编号:131460613) 河北省科技计划项目(编号:14277758D) 河北省中医药管理局项目(编号:2014221)
【分类号】：R736.3;R746.1

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