三种不同剂量激素治疗狼疮脑病的临床疗效研究

目的 :探讨不同剂量的甲基强的松龙对狼疮脑病的临床疗效。方法 :对该院 33例确诊为狼疮脑病的患者采用三种不同剂量的甲基强的松龙 (12 0mg ,5 0 0mg ,10 0 0mg) ,加环磷酰胺、鞘内注药治疗 ,比较其疗效及副反应。结果 :缓解率 12 0mg组为 88.8% ,5 0 0mg组为 88.8% ,10 0 0mg组为 84 .6 % ,无显著性差异 (P >0 .0 5 )。10 0 0mg组死亡率为 6 .7% ,且并发感染 2例 (13.3% ) ,上消化道出血 1例 (6 .7% ) ,另两组均为 0。结论 :对于狼疮脑病 ,12 0mg或 5 0 0mg甲基强的松龙能达到 10 0 0mg的相应疗效且感染、消化道出血的副作用发生率低。

CLINICAL EFFECTS OF METHYLPREDNISOLONE OF THREE DOSAGE ON CENTRAL NERVOUS SYSTEM INVOLVEMENT IN SYSTEMIC LUPUS ERYTHEMATOSUS

Objective:To analyse the effect of methylprednisolone of different dosage on systemic lupus erythematosus with central nervous system involvement (CNS-SLE).Method:Thirty-three hospitalized patients with CNS-SLE were included in this study. The patients were randomly divided into three groups and treated with different dose of Methylprednisolone (120mg, 500mg, 1000mg). Besides Methylprednisolone, all patients were routinely treated with Cyclophosphamide.Those of central nervous system lupus were additionally treated with intrathecal injection of Methotrexate and Dexamethasone. We compared the curative effect and side effect in the three groups. Results:The curative effect rates of three groups were 88.8%, 88.8% and 84.6% respectively. There was no difference among the three groups( P > 0.05). The infection rates were 0%, 0% and 13.3% respectively.Contrasting to the first and second group, two patients of the third group were attacked with gastrointestinal hemorrhage, one of them died. The mortality rates were 0%, 0% and 6.7% respectively.Conclusion:For the patients of CNS-SLE,treatment of high-dose Methylprednisolone of 120mg and 500mg can reach the similar curative effect of 1000mg, and the infection, gastrointestinal hemorrhage rates are lower.