甲泼尼龙与丙种球蛋白联合治疗成人急性播散性脑脊髓炎的疗效

目的评价甲泼尼龙与丙种球蛋白联合治疗成人急性播散性脑脊髓炎(ADEM)的临床疗效。方法对42例诊断为ADEM的成人患者进行回顾性研究,按主要的治疗方法分为甲泼尼龙加丙种球蛋白(MPS+IG)组及甲泼尼龙(MPS)组,以2组患者Kurtzke神经功能障碍量表(EDSS)评分反映疗效,比较两组治疗7d、15d的EDSS评分及复发情况。结果治疗7d时MPS+IG组的EDSS评分为2.7±1.5,明显低于MPS组的EDSS评分3.8±1.7(P<0.05),治疗15d时两组的EDSS评分及随访期间的复发病例差异均无统计学意义(P>0.05)。结论甲泼尼龙与丙种球蛋白联合治疗成人ADEM在治疗早期可明显改善临床症状,加快病情好转,效果优于单用甲泼尼龙治疗。

Effect of methylprednisolone combined with immunoglobulin in the treatment of adult patients with acute disseminated encephalomyelitis

Objective To evaluate the effect of methylprednisolone combined with immunoglobulin on adult patients with acute disseminated encephalomyelitis(ADEM).Methods A retrospective study was conducted in 42 adult patients with the diagnosis of ADEM.The patients were divided into two groups:methylprdnisolone combined with immunoglobulin group(MPS+IG),and methylprednisolone group(MPS).The effects of 2 groups were compared by the scores of Kurtzke expanded disability status scale(EDDSS)before and after therapy,as well as the recurrent cases.Results The EDSS scores in MPS+IG group and MPS group were(2.7±1.5)and(3.8±1.7)respectively,after 7 d of treatment,there were statistical differences between them(P<0.05).But there was no significant difference between them in EDSS scores after 15 d of treatment,as well as the recurrent cases(P>0.05).Conclusion Methylprednisolone combined with immunoglobulin on adult patients with ADEM prevails in short-term efficacy.