大剂量甲泼尼龙治疗重症肌无力的临床疗效及对血清补体的影响

目的：观察大剂量甲泼尼龙治疗重症肌无力（MG）的临床效果及对血清补体的影响。方法：对大剂量甲泼尼龙冲击（MPPT）治疗的32例MG病人于治疗前及治疗后分别进行临床评分、疗效观察和血清乙酰胆碱受体抗体（AChRAb）、C3、C4检测。结果：MPPT治疗MG后，1周时临床显效率56．3％（18／32），3月时临床显效率为81．3％（26／32），总有效率为93．8％（30／32）。治疗3月后血清AchRAb水平明显高于对照组，C3、C4水平明显低于对照组（P〈0．05）；经治疗后患者血清AchRAb水平明显降低，C3、C4水平明显增高，较治疗前差异显著（P〈0．05）、结论：大剂量甲泼尼龙冲击治疗MG见效快，冲击后能维持临床缓解，可促进C3、C4水平升高，值得临床广泛应用。

Therapeutic Effect of Large Dose of Methylprednisolone on Myasthenia Gravis and Its Effect on Serum Complement

OBJECTIVE： To observe the therapeutic effect of large dose of methylprednisolone on myasthenia gravis （MG） and its effect on serum complement. METHODS： Thirty-two patients with definite MG were treated with large dose of methylprednisolone pulse therapy （MPPT）. Before and after treatment, the clinical scores, therapeutic effect were observed, and serum acetylcholine receptor antibody （AchRAb） titers and C3 and C4 levels were measured. RESULTS： One week after MPPT treatment, the clinical response rate reached 56.3% （18/32）, and increased to 81.3% （26/32） at 3 months, with a total effective rate of 93.8% （30/32）. Serum AchRAb titers were significantly higher and C3 and C4 levels were significantly lower than in control group （P 〈 0.05） after three-month treatment. AchRAb titers decreased significantly and C3 and C~ levels increased significantly after treatment comparing with before treatment （P 〈 0.05）. CONCLUSION： The treatment of large dose of methylprednisolone on myasthenia gravis （MG） achieved rapid response and effective clinical anesis, and it elevated the levels af C3 and C4, thus deserving to be widely used in the clinic.