特发性炎症性肌病的治疗进展 |
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引用本文: | 贾复敏,卜碧涛. 特发性炎症性肌病的治疗进展[J]. 神经损伤与功能重建, 2011, 6(5): 313-319 |
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作者姓名: | 贾复敏 卜碧涛 |
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作者单位: | 贾复敏 (华中科技大学同济医学院附属同济医院神经内科,武汉,430030) ; 卜碧涛 (华中科技大学同济医学院附属同济医院神经内科,武汉,430030) ; |
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摘 要: | 口服大剂量激素是PM/DM的主要治疗方案.口服激素联合静脉注射免疫球蛋白(IVIG)是伴有吞咽、呼吸困难等危及生命的严重全身并发症的多发性肌炎/皮肌炎(PM/DM)患者的一线治疗.甲氨蝶呤或硫唑嘌呤是激素无效患者的一线非激素类免疫抑制剂.甲氨蝶呤常联合硫唑嘌呤、骁悉或美罗华用于激素无效的PM/DM患者,但尚未达到临床共...
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关 键 词: | 特发性炎症性肌病 多发性肌炎 皮肌炎 包涵体肌炎 治疗 |
Progress in the Treatment of Idiopathic Inflammatory Myopathy |
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Abstract: | High-dose oral glucocorticoid is commonly used for PM/DM treatment.The combination of oral glucocorticoid with intravenous immunoglobulins(IVIG) is recommended to be the primary therapy for patients with PM/DM-related severe systemic complications,especially exhibiting life-threatening esophageal involvement or dyspnea.Methotrexate or azathioprine is the primary immunosuppressive therapy for patients who fail to respond to glucocorticoid therapy.Methotrexate,in combination with Mycophenolate mofetil or rituximab can be used for the steroid-resistant patients,although there is no general clinical consensus.TNF-α antagonists should not be recommended for PM/DM patients.IBM is resistant to standard immunosuppressants.The overall efficacy of IVIG on patients with IBM is unsatisfactory.Alemtuzumab may be effective for IBM. |
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Keywords: | idiopathic inflammatory myopathy polymyositis dermatomyositis inclusion body myositis treatment |
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