来氟米特联合泼尼松治疗多发性肌炎的临床观察

发布时间：2018-06-29 16:47

本文选题：来氟米特 + 泼尼松　；参考：《中国药房》2017年15期

【摘要】：目的:观察来氟米特联合泼尼松治疗多发性肌炎的疗效和安全性。方法:选取我院收治的98例多发性肌炎患者,按随机数字表法分为观察组和对照组,每组49例。对照组患者给予泼尼松片口服,初始给药剂量为60~100 mg/d,每日3次,然后根据患者肌酸肌酶(CK)及临床症状的改善情况逐渐减量至维持剂量10 mg/d,每日3次。观察组患者在对照组治疗基础上加服来氟米特片10 mg,每日2次。两组疗程均为120 d。观察两组患者临床疗效和肌力评价情况,比较治疗前后肌酶谱[包括CK、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)、肌酸磷酸激酶(CPK)、丙氨酸转氨酶(ALT)]、血清炎症因子水平[包括白细胞介素2(IL-2)、IL-8、IL-12、肿瘤坏死因子α(TNF-α)和超敏C反应蛋白(hs-CRP)]水平,同时记录不良反应发生情况。结果:治疗后观察组患者临床总有效率(87.8%)和肌力达3级率(81.6%)均显著高于对照组(分别为75.5%、55.1%),总不良反应发生率显著低于对照组(12.2%vs.22.4%),差异均有统计学意义(P0.05)。治疗后,两组患者肌酶谱和血清炎症因子水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P0.05)。结论:来氟米特联合泼尼松治疗多发性肌炎疗效较好,可以显著提升患者肌力,改善肌酶谱和血清炎症因子水平,且安全性较好。
[Abstract]:Objective: to observe the efficacy and safety of leflunomide combined with prednisone in the treatment of polymyositis. Methods: 98 patients with polymyositis were randomly divided into observation group and control group with 49 cases in each group. In the control group, prednisone tablets were given orally at an initial dose of 60 ~ 100 mg / d, 3 times a day, and then gradually reduced to 10 mg / d, 3 times a day, according to the improvement of creatine creatinase (CK) and clinical symptoms. The patients in the observation group received leflunomide 10 mg on the basis of treatment in the control group, twice a day. The course of treatment was 120 days in both groups. To observe the clinical curative effect and muscle strength evaluation of the two groups, Before and after treatment, the levels of muscle enzymes [including CK2, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatine phosphokinase (CPK), alanine aminotransferase (alt)], serum inflammatory factors [including interleukin-2 (IL-2) IL-8 IL-12, tumor necrosis factor- 伪 (TNF- 伪) and hypersensitive C-reactive protein (hs-CRP)] were compared. Adverse reactions were also recorded. Results: the total effective rate (87.8%) and muscle strength (81.6%) were significantly higher in the observation group than in the control group (75.5%, 55.1%), and the incidence of total adverse reactions was significantly lower than that in the control group (12.2vs.22.4%) (P0.05). After treatment, the levels of myozyme and serum inflammatory factors in the two groups were significantly lower than those in the same group before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P0.05). Conclusion: leflunomide combined with prednisone is effective in the treatment of polymyositis.
【作者单位】：襄阳市中心医院神经内科;湖北省南漳县中医院;
【分类号】：R542.21

【相似文献】