大剂量甲泼尼龙冲击疗法治疗视神经脊髓炎的疗效观察
注意：本论文已在《世界临床药物》2003年03期 2003 Vol.24 No.3 P.141-144发表
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贺斌 邵福源
第二军医大学附属长征医院神经内科,上海,200003
摘要：目的：观察大剂量甲基强地松龙冲击治疗NMO急性发作病人的临床疗效。方法：对21例临床确诊为NMO急性发作的病人应用甲基强的松龙1000mg，静滴3天，然后改甲基强的松龙80 mg静滴3天，再以强的松30 mg口服，一个月内逐渐减量至停药。采用Barthel指数对病人入院后第3天和治疗后第15天的日常生活能力进行评价，采用近视力表对病人治疗前后相同时间内的视力进行比较。结果：21例病人经过大剂量甲基强的松龙冲击治疗后，其中17例病人疗效显著，占80.9%，其日常生活能力得到明显改善； 4例病人治疗无效。病人入院第3天的Barthel 指数总评分与治疗第15天的总评分相比有显著差别。21例病人治疗后的视力与治疗前相比有显著的改善。结论：大剂量甲基强的松龙冲击疗法对NMO病人的急性发作治疗有效。
关键词: 视神经脊髓炎; 甲基强地松龙; Barthel 指数评分
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 Finally, prednisolone, 30mg, was administered orally to the patients everyday and grdually withdrawn within a month.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
作者简介：贺斌:临床硕士研究生,主治医生,对中枢神经系统炎症、睡眠障碍、脑血笾病等有所研究.曾获"首届长征新星奖",第二军医大学"A"级优秀教员称号.
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