Sellebjerg F, Frederiksen J L, Nielsen P M, Olesen J
Neurologisk afdeling, Amtssygehuset i Glostrup.
Ugeskr Laeger. 1999 Nov 29;161(48):6625-9.
The efficacy of glucocorticoid treatment in multiple sclerosis (MS) is uncertain. We assessed the effect of oral high-dose methylprednisolone in attacks of MS. Twenty-five patients with an attack of MS with a duration of less than four weeks were randomized to placebo, 26 patients received oral methylprednisolone (500 mg once daily for five days with a 10 days tapering period). Scripps Neurological rating scale scores differed significantly in methylprednisolone and placebo-treated patients the first three weeks (p = 0.005) and after eight weeks (p = 0.0007). Subjective symptom assessment on a visual analogue scale the first three weeks (p = 0.02) and the answers to an efficacy questionnaire administered after eight weeks (p = 0.05) also favoured a beneficial effect of methylprednisolone treatment. The risk of a new attack of MS was not influenced by the treatment at short-term follow up. No serious adverse events were seen. Oral high-dose methylprednisolone is recommended for treatment of attacks of MS.
糖皮质激素治疗多发性硬化症（MS）的疗效尚不确定。我们评估了口服大剂量甲泼尼龙对MS发作的影响。25例病程少于四周的MS发作患者被随机分配至安慰剂组，26例患者接受口服甲泼尼龙（每日一次，500mg，共五天，随后10天逐渐减量）。在前三周（p = 0.005）和八周后（p = 0.0007），甲泼尼龙治疗组和安慰剂治疗组的斯克里普斯神经学评分量表得分存在显著差异。在前三周采用视觉模拟量表进行的主观症状评估（p = 0.02）以及八周后进行的疗效问卷调查结果（p = 0.05）也都表明甲泼尼龙治疗具有有益效果。在短期随访中，治疗并未影响MS再次发作的风险。未观察到严重不良事件。推荐口服大剂量甲泼尼龙用于治疗MS发作。
