中剂量环磷酰胺治疗难治性全身型重症肌无力17例分析

目的:探讨中剂量环磷酰胺对难治性重症肌无力(RMG)的有效性、安全性和使用方法。方法:17例RMG住院患者均采用环磷酰胺治疗30 d后,回顾性分析其发病年龄、性别、临床类型及伴发病与环磷酰胺疗效的关系。结果:治疗后随访2个月-2年(平均1年),有效率达91.3%,终点疗效与发病年龄、性别、临床类型、有无伴发胸腺瘤及手术无相关性,出现的副作用有呕吐1例、轻度白细胞计数降低5例、一过性转氨酶升高3例、脱发1例。结论:中剂量环磷酰胺治疗RMG疗效肯定,副作用少且轻微,1次治疗后症状稳定缓解可达数月。

Analysis of Median-dose Cyclophosphamide Treatment in 17 Patients with Refractory Myasthenia Gravis

Objective: The efficacy,side-effects,and using method of median dose cyclophosphamide(MDC) therapy in 17 patients with refractory myasthenia gravis(RMG) were analyzed.Methods: Seventeen hospitalized patients with RMG treated with MDC have been retrospectively analyzed in terms of the influence of patients' ages at onset,sex,clinical types and the accompanying disorders on efficacy of cyclophosphamide therapy.Results:During a follow-up of 0.2-2 years,the total effectiveness rate was 91.3%,and the efficacy had no relation with age at onset,sex,clinical types,thymoma and thymectomy.The major side-effects included vomiting,myelosuppression,increased transient alanine aminotransferase and alopecie.Conclusion:The MDC therapy appeared to be an effective and safe therapy for RMG based on the comparison after the therapy.Further case-controlled,double-blinded studies of more patients are needed to evaluate the long-term outcome in refractory generalized MG patients.