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目的探讨他克莫司治疗重症肌无力患者的临床效果及安全性。方法选取2015年1—12月医院收治的150例重症肌无力患者作为研究对象,按入院时间先后将其分为观察组与对照组,各75例。对照组患者给予甲基强的松龙,观察组患者则给予他克莫司。测定两组患者持续治疗4个月后治疗效果,同时使用日常生活能力量表(ADL)、美国MG基金会(MGFA)疾病严重程度评价量表、徒手肌力评定(MMT)以及Osserman对患者治疗前后日常生活能力、病情相关指标变化情况进行评估,统计患者治疗前后体内乙酰胆碱受体抗体(Ach R-Ab)浓度及治疗期间不良反应发生情况。结果观察组患者治疗的总有效率明显高于与对照组,差异有统计学意义(P<0.05);治疗后,观察组患者的临床相对评分以及Osserman评分均明显低于对照组,ADL评分、MGFA疾病严重程度评价量表评分、MMT评分均明显高于对照组,差异均有统计学意义(均P<0.05);治疗后,观察组患者的Ach R-Ab浓度明显低于对照组,差异有统计学意义(P<0.05)。结论他克莫司治疗重症肌无力患者相较于传统甲基强的松龙治疗效果显著,可有效降低患者体内Ach R-Ab水平,缓解肌无力等症状,提高生活能力,且安全性高。
Objective To investigate the clinical effect and safety of tacrolimus in patients with myasthenia gravis. Methods A total of 150 patients with myasthenia gravis treated in our hospital from January to December in 2015 were enrolled in this study. They were divided into observation group and control group according to the time of admission. Patients in the control group were given methylprednisolone while those in the observation group were given tacrolimus. The therapeutic effect was measured after 4 months of continuous treatment in both groups. The ADL, MGFA, MMT and Osserman were used to treat the patients Before and after the daily living ability, the changes of disease-related indicators to assess the status of patients before and after treatment of acetylcholine receptor antibody (Ach R-Ab) concentration and adverse reactions during treatment. Results The total effective rate of observation group was significantly higher than that of the control group (P <0.05). After treatment, the clinical relative score and Osserman score of the observation group were significantly lower than that of the control group, ADL score, MGFA disease severity scale, MMT score were significantly higher than the control group, the difference was statistically significant (all P <0.05); after treatment, the observation group Ach R-Ab concentration was significantly lower than the control group, the difference There was statistical significance (P <0.05). Conclusion Tacrolimus treatment of patients with myasthenia gravis compared with the traditional treatment of methylprednisolone significant effect, which can effectively reduce the level of Ach R-Ab in patients, to alleviate the symptoms such as muscle weakness and improve life skills, and high safety.