大剂量甲泼尼龙冲击治疗急性球后视神经炎疗效分析

目的:分析大剂量甲泼尼龙冲击治疗急性球后视神经炎的临床效果,探讨安全有效的治疗方案。方法:选取2007年12月～2011年6月在我科治疗的急性球后视神经炎患者66例(112眼),随机分为对照组和观察组各33例(每组56眼),对照组采取地塞米松常规治疗,观察组采取甲泼尼龙冲击治疗,比较两组患者的近期、远期治疗效果及副作用。结果:治疗7d后,观察组治疗效果明显优于对照组(P<0.05),差异具有统计学意义;治疗3个月后,两组患者有效率差异不明显(P>0.05),差异无统计学意义。经比较发现,观察组不良反应如颜面潮红,兴奋失眠,上消化道不适,血糖、血压升高,低血钾的发生率明显高于对照组(P<0.05),差异具有统计学意义。结论:大剂量甲泼尼龙冲击治疗早期可改善急性球后视神经炎视力等功能恢复,但是长期疗效与常规剂量治疗无明显差别,并且大剂量冲击治疗下有多种不良反应。

Curative effect of large dose of methylprednisolone on acute retrobulbar neuritis

Objective: To investigate the curative effects of large dose methyl-prednisoxlone therapy on acute retrobulbar neuritis,and to explore a safe and effective treatment for the disease.Methods: A total of 66 cases(112 eyes) admitted to our hospital from December 2007 and June 2011 were randomly divided into observation group and control group with 33 cases in each group(n=56 eyes).The control group was given conventional therapy of dexamethasone,while the observation group was treated with methylprednisolone pulse therapy.Recent and long term therapeutic effects as well as side effects were observed and compared.Results:After 7 days of treatment,the observation group showed significant better therapeutic effects than the control group(P<0.05),but the difference was not significant after 3 months of treatment(P>0.05).The observation group showed significant higher incidence of adverse reactions such as facial flushing,excited insomnia,gastrointestinal discomfort,glucose,elevated blood pressure,low blood potassium than the control group(P<0.05).Conclusions: High-dose methylprednisolone pulse therapy can improve the acute retrobulbar optic neuritis in early stage,but the long term efficacy was not significantly differed from that of the conventional dose therapy,besides,high-dose therapy may induce multiple adverse reactions.