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目的 探讨门诊长期使用醋酸泼尼松治疗重症肌无力 (MG)的有效性、安全性和使用方法。方法 对 6 0 0例使用“泼尼松中剂量冲击、小剂量维持”口服疗法的MG患者进行前瞻性研究 ,观察泼尼松使用剂量、撤药方式与疗效和副反应的关系 ,并分析MG类型、年龄、病程及伴发病对疗效的影响。结果 追踪 1～ 12年 (平均约 4年 ) ,总有效率为 94.6 % ,终点的疗效与临床类型、发病年龄、病程及胸腺瘤无明显关联。 2 38例患者按计划撤药 ,有 82例 (34 .5 % )症状复发 (药物依赖 )。主要副反应为Cushing反应和易患上呼吸道感染。结论 泼尼松可用于所有类型MG的长期治疗 ,儿童及成人均适用。Cushing反应随药物减量逐渐消失 ,但易患上呼吸道感染和儿童体格矮小不容忽视。药物依赖的发生率很高 ,自制中成药扶正强筋片对此有一定帮助。
Objective To investigate the effectiveness, safety and usage of long-term prednisone acetate in the treatment of myasthenia gravis (MG). Methods A total of 600 patients with MG treated with “Prednisone medium dose shock and low dose maintenance” oral therapy were prospectively studied. The relationship between dose and withdrawal mode of prednisone, curative effect and side effects was observed. The effects of age, course of disease and complication on the curative effect. Results The follow-up ranged from 1 to 12 years (mean, about 4 years). The total effective rate was 94.6%. The efficacy of the end point was not significantly associated with the clinical type, age of onset, duration of disease and thymoma. Twenty-eight patients were scheduled for withdrawal, with 82 (34.5%) recurrences (drug dependence). The main side effects of Cushing reaction and susceptible upper respiratory tract infection. Conclusion Prednisone can be used for the long-term treatment of all types of MG, both children and adults. Cushing reaction with the drug gradually diminished, but susceptible to upper respiratory tract infections and children with short stature can not be ignored. The incidence of drug dependence is very high, homemade proprietary Chinese medicine is strong gluten tablets have some help.