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目的:探讨甲氨蝶呤联合糖皮质激素治疗皮肌炎患者的安全性。方法:将2016年6月-2017年6月在我院风湿免疫科治疗的76例皮肌炎患者随机分为两组,对照组采用糖皮质激素治疗,观察组采用甲氨蝶呤联合糖皮质激素治疗,比较两组患者的临床疗效、肌酶谱水平变化、不良反应。结果:观察组治疗有效率为94.74%,明显高于对照组的73.68%,两组间有统计学差异(P<0.05);观察组治疗后丙氨酸转氨酶、天冬氨酸转氨酶、肌酸磷酸激酶、乳酸脱氢酶水平明显低于对照组,两组间有统计学差异(P<0.05);观察组上腹部不适、血压升高、白细胞降低、血糖升高等不良反应发生率明显低于对照组,两组间有统计学差异(P<0.05)。结论:甲氨蝶呤联合糖皮质激素治疗皮肌炎效果显著,抑制异常免疫反应,症状改善明显,且不良反应轻微,具有积极的临床意义。
Objective: To investigate the safety of methotrexate combined with glucocorticoid in patients with dermatomyositis. Methods: Sixty-six patients with dermatomyositis treated in our department from June 2016 to June 2017 were randomly divided into two groups. The control group was treated with glucocorticoid. The observation group was treated with methotrexate combined with glucocorticoids Hormone therapy, the clinical efficacy of two groups were compared, the level of muscle zymogram changes, adverse reactions. Results: The effective rate of the observation group was 94.74%, which was significantly higher than that of the control group (73.68%) (P <0.05). The changes of alanine aminotransferase, aspartate aminotransferase, creatine The levels of phosphokinase and lactate dehydrogenase were significantly lower than those of the control group (P <0.05). The adverse reactions such as upper abdominal discomfort, blood pressure, leukopenia and hyperglycemia in the observation group were significantly lower than those in the control group The control group, there was a significant difference between the two groups (P <0.05). CONCLUSION: Methotrexate combined with glucocorticoid has significant therapeutic effect on dermatomyositis, which can inhibit the abnormal immune response and improve the symptoms with mild side effects. It has a positive clinical significance.