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目的探讨甲泼尼龙冲击治疗在儿童重症肌无力中治疗效果。方法选取本院2008年10月~2013年10月期间收治的重症肌无力患儿共33例,本组所选患儿均实施大剂量甲泼尼龙冲击疗法,给予甲泼尼龙剂量为每天20 mg/kg加入5%葡萄糖注射液中静脉缓慢滴注,连续用药3 d,而后改为泼尼松口服,剂量为每天2 mg/kg,连续口服4 d,上述用药时间为1个疗程,共进行2~3个疗程。结果本组患儿治疗后临床效果评定:完全缓解患儿共17例,部分缓解患儿共14例,2例患儿治疗效果无效,治疗有效病例共31例,有效率为93.9%。本组患者治疗过程中平均起效时间为3.5 d。2例治疗无效患儿中,1例患儿加用溴吡斯的明后缓解,另1例患儿给予大剂量免疫球蛋白治疗后,症状没有改善,而后加用溴吡斯的明后症状得到缓解。所选患者进行随访,随时最短时间为3个月,最长为2年,其中4例患儿复发,2例患儿在完全缓解后停药后出现复发,1例患儿在服用泼尼松减量过程中出现复发,1例患儿在发生上呼吸道感染后出现复发。结论甲泼尼龙冲击治疗儿童重症肌无力可获得较好治疗效果,能够在较短时间内改善患儿症状,值得借鉴。
Objective To investigate the therapeutic effect of methylprednisolone in children with myasthenia gravis. Methods Totally 33 children with myasthenia gravis treated in our hospital from October 2008 to October 2013 were enrolled. All the children in this group were treated with high-dose methylprednisolone therapy. The dose of methylprednisolone was 20 mg daily / kg added 5% glucose injection intravenous slow infusion, continuous medication 3 d, and then changed to prednisone, a daily dose of 2 mg / kg, continuous oral 4 d, the above medication for a course of treatment, a total of 2 to 3 courses. Results After treatment, the clinical efficacy of this group was evaluated: totally 17 cases of children with complete remission, 14 cases of partial remission in children, 2 cases of children with ineffective treatment, a total of 31 cases of effective treatment, the effective rate was 93.9%. The average duration of onset of treatment in this group of patients was 3.5 d. Among the 2 children who failed to respond to treatment, 1 patient was relieved with pyridoside and the other 1 patient was treated with high-dose immunoglobulin. The symptoms did not improve, Be relieved. The selected patients were followed up for a minimum of 3 months and a maximum of 2 years, of which 4 patients relapsed, 2 patients relapsed after discontinuation of complete remission, and 1 patient was prednisone Relapse occurred during the reduction and 1 patient developed recurrence after upper respiratory infection. Conclusion Methylprednisolone treatment of children with myasthenia gravis can get a better therapeutic effect, can improve the symptoms in children in a relatively short period of time, it is worth learning from.