Douglas J G, Ford M J, Innes J A, Munro J F
Eur J Clin Invest. 1979 Apr;9(2 Pt 1):137-40. doi: 10.1111/j.1365-2362.1979.tb01679.x.
In a series of thirty-seven consecutive patients with polymyalgia arteritica, twenty-five had polymyalgia rheumatica and twelve had cranial arteritis. Some failed to respond promptly to low doses of prednisolone and it is recommended that the initial dose should be in the order of 40 mg daily. An ESR above 40 mm in the first hour was present in four patients 3 months after admission; three were found to have rheumatoid disease and one pulmonary tuberculosis. Symptomatic relapses occurred in fourteen patients on twenty-one occasions and all responded to an increase in the daily dose of maintenance prednisolone. Most occurred in the first year and were attributable to an excessively rapid reduction in steroid therapy. Relapses occurring in patients on a stable dose of prednisolone were commonly associated with the development of rheumatoid disease. In elderly patients who have relapsed, or who have had arteritic complications, life-long prednisolone therapy appears justifiable.
在连续的37例多发性肌炎动脉炎患者中，25例患有风湿性多肌痛，12例患有颅动脉炎。一些患者对低剂量泼尼松龙反应不迅速，建议初始剂量应为每日40毫克左右。入院3个月后，4例患者第1小时血沉超过40毫米；3例被发现患有类风湿病，1例患有肺结核。14例患者出现21次症状复发，所有患者均对维持泼尼松龙每日剂量增加有反应。大多数复发发生在第一年，归因于类固醇治疗减量过快。服用稳定剂量泼尼松龙的患者复发通常与类风湿病的发展有关。在复发或有动脉炎并发症的老年患者中，终身泼尼松龙治疗似乎是合理的。
