糖皮质激素不同给药方式治疗急性期多发性硬化的疗效观察

目的探讨糖皮质激素3种不同给药方式治疗急性期多发性硬化(multiple sclerosis，MS)的疗效及安全性。方法将1998～2002年于我科治疗的48例MS患者按主要治疗方法的不同分为鞘内注入地塞米松(DXM)组、甲基强的松龙(MPS)冲击组及常规使用激素组。比较治疗后各组不同时间的Kurtzke扩充致残量表(Kurtzke expanded disability status scale，EDSS)评分减少数及副作用的发生率。结果鞘内注入DXM组治疗早期EDSS评分减少较其它两组显著，尤其对于脊髓受累为主的MSEDSS评分改善更为明显。结论鞘内注入DXM与两种常规方法比较见效快，建议用于脊髓受累为主的急性期MS。

Contrastive studies of different administration pathway of dexamethasone in treatment of acute relapsing multiple sclerosis

Objective To evaluate the effect and reliability of three different administration pathways of glucocorticoids for acute multiple sclerosis(MS). Methods We reviewed 48 cases suffered from acute multiple sclerosis and received treatment in our department from 1998 to 2002. All of these cases were divided into three groups as intrathecal desamethasone group,methylprednisolone impact group and routinly given glucocorticoids group,then evaluated the reduction of Kurtzke expanded disability status scale (EDSS) and the rate of side effects at different time after treatment. Results The improvement of EDSS scale of intrathecal desamethasone group were significantly obvious compared with the other two groups during earlier period of treatment,especially to the cases mainly involved in spinal cords. Conclusion Intrathecal DXM therapy worked faster compared with the other two groups,and should be suggested for acute MS mainly involved in spinal cords.