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1958年Arth氏和Johnston等氏合成Dexamethasone,此为最新腎上腺皮质激素类之一,由Prednisolone 9-α位加氟,16-α-位加甲基而成。Prednisolone 9-α位加氟,抗炎及抗过敏作用增加10倍,16—α位再导入甲基,則大大地消除对水盐及电解质的影响,同时增强抗炎及抗过敏的作用。 Dexamethasone的临床功效相当于Cortisone的30倍,Predinisolone的六倍,对水盐及电解质的平衡几乎不发生影响,对胃腸的刺激也是很小。Arth氏由肉芽瘤抑制試驗証实Dexamethasone抗炎作用远较Hydrocortisone为强,而促进血糖及引起电解质紊乱的現象很輕。小辰治氏认为Dexamethasone适于长期治疗慢性皮肤疾患。近一年来,我科应用Dexamethasone治疗八例住院病人(皮肌炎三例,天疱疮二例,疱疹状皮炎、类天疱疮及湿疹各一例)。临床上都取得了明显疗效,皮肌炎症状显著緩解,水疱性疾病及湿疹皮損完全消失。
1958 Arthur and Johnston et al synthesis of Dexamethasone, which is one of the latest adrenal cortical hormones, Prednisolone 9-α-plus fluoride, 16-α-plus methyl. Prednisolone 9-α position fluoride, anti-inflammatory and anti-allergic effects increased 10-fold, 16-α-bit into the methyl, then greatly reduce the water and salt and electrolyte, while enhancing anti-inflammatory and anti-allergic effects. The clinical efficacy of Dexamethasone is equivalent to 30 times that of Cortisone and 6 times that of Predinisolone. Almost no effect on the balance of water and salt and electrolytes, and gastrointestinal irritation is also small. Arthur’s inhibition of granuloma inhibition confirmed that Dexamethasone is far more potent anti-inflammatory agent than Hydrocortisone and promotes glucose and electrolyte imbalances. Small Chen Zhi believes that Dexamethasone is suitable for long-term treatment of chronic skin disorders. In the past year, our department has used Dexamethasone to treat eight inpatients (three cases of dermatomyositis, two cases of pemphigus, one case of herpes dermatitis, one case of pemphigoid and eczema). Obvious effect has been clinically achieved, dermatomyositis symptoms significantly relieved, vesicular disease and eczema lesions completely disappear.