Yilmaz O, Karaduman A, Topaloğlu H
Hacettepe University School of Physiotherapy, Ankara, Turkey.
Eur J Neurol. 2004 Aug;11(8):541-4. doi: 10.1111/j.1468-1331.2004.00866.x.
Steroids may have a beneficial effect on the course of Duchenne muscular dystrophy (DMD). However, results vary in different studies. This study consisted of 66 DMD boys who were in the therapy group and 22 DMD boys in the control group. The mean ages were 6.8 +/- 2.1 years (range 2.5-12.5) and 7.0 +/- 1.3 years (range 5.0-9.0), respectively. We assessed muscle strength, 10-m walking, ankle contracture, and loss of independent walking ability age and onset of scoliosis. Treatment regimen was oral prednisolone 0.75 mg/kg on alternate days, plus vitamin D 600-1200 units/day and a calcium-enriched diet. After a follow-up period of 2.75 +/- 1.1 years (range 1.5-5) and when compared with controls, there was a statistically significant change in muscle strength between the two groups after 12 months (P < 0.05). Although 10-m walking time decreased in therapy group (P < 0.05), there was not significance between the groups in the end. Boys in the control group developed significantly less ankle contractures (P < 0.05). None of the therapy group had scoliosis during the follow-up period (mean age 10.8 +/- 1.2 years), whereas seven boys of the control group had scoliosis at a mean age of 11.7 +/- 2 years. Loss of walking ability age was statistically different between groups (P < 0.05). Our results indicate that, alternate-day prednisolone regimen may prolong ambulation and scoliosis can be delayed or prevented.
类固醇可能对杜氏肌营养不良症(DMD)的病程产生有益影响。然而,不同研究的结果存在差异。本研究包括66名接受治疗的DMD男孩和22名作为对照组的DMD男孩。平均年龄分别为6.8±2.1岁(范围2.5 - 12.5岁)和7.0±1.3岁(范围5.0 - 9.0岁)。我们评估了肌肉力量、10米步行能力、踝关节挛缩、独立行走能力丧失的年龄以及脊柱侧弯的发病情况。治疗方案为隔日口服泼尼松龙0.75 mg/kg,加维生素D 600 - 1200单位/天以及富含钙的饮食。经过2.75±1.1年(范围1.5 - 5年)的随访期,与对照组相比,两组在12个月后肌肉力量有统计学上的显著变化(P < 0.05)。虽然治疗组的10米步行时间减少(P < 0.05),但最终两组之间无显著差异。对照组男孩发生踝关节挛缩的情况明显较少(P < 0.05)。在随访期间(平均年龄10.8±1.2岁),治疗组中无人出现脊柱侧弯,而对照组中有7名男孩在平均年龄11.7±2岁时出现了脊柱侧弯。两组之间丧失行走能力的年龄存在统计学差异(P < 0.05)。我们的结果表明,隔日泼尼松龙治疗方案可能会延长行走时间,并且可以延迟或预防脊柱侧弯。