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[胸腺五肽治疗扩大胸腺切除术后复发:135例重症肌无力患者的随机对照临床试验]

[Thymopentin 5 in treatment of relapse after extended thymectomy: a randomized comparative clinical trial of 135 patients with myasthenia gravis].

作者信息

Liu Wei-bin, He Xue-tao, Chen Zhen-guang, Zhang Ying, Huang Xin, Huang Ru-xun

机构信息

Department of Neurology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Aug 26;88(33):2335-8.

Abstract

OBJECTIVE

To investigate the effect of thymopentin 5 (TP5) combined with immunosuppressive agents in treatment of relapse after extended thymectomy in patients with myasthenia gravis (MG).

METHODS

One hundred thirty-five MG patients who were to undergo extended thymectomy, 62 adults and 73 children, were randomly assigned to 2 groups: non-TP5 group (n = 60) treated with intramuscular injection of prednisone + pyridostigmine daily for 3 months as a basic treatment, and TP5 group (n = 73), treated with prednisone + pyridostigmine + TP5 for 3 months. Follow-up was conducted for more than 1 year.

RESULTS

The remission rates of children in the TP5 group at different time points were all markedly higher than those in the non-TP5 group, and the remission rates of children in the TP5 group during the period of 2 months to 2 years after thymectomy were all significantly higher (all P < 0.05). And the remission rates of the adults of the TP5 group during the period of 6 months to 2 years after thymectomy were all significantly higher than those of the non-TP5 group (all P < 0.05). In the pediatric cases the withdrawal rate of the TP5 group was significantly higher, and the relapse rate was significantly lower than those of the non-TP5 group. No side effect developed during the follow-up.

CONCLUSION

TP5 is effective in reducing relapse and has a higher drug withdrawal rate, especially among children.

摘要

目的

探讨胸腺五肽(TP5)联合免疫抑制剂治疗重症肌无力(MG)患者扩大胸腺切除术后复发的效果。

方法

135例拟行扩大胸腺切除术的MG患者,其中成人62例,儿童73例,随机分为2组:非TP5组(n = 60),以每日肌内注射泼尼松+吡啶斯的明治疗3个月作为基础治疗;TP5组(n = 73),以泼尼松+吡啶斯的明+TP5治疗3个月。随访1年以上。

结果

TP5组儿童在不同时间点的缓解率均明显高于非TP5组,且TP5组儿童在胸腺切除术后2个月至2年期间的缓解率均显著更高(均P < 0.05)。TP5组成人在胸腺切除术后6个月至2年期间的缓解率均显著高于非TP5组(均P < 0.05)。在儿科病例中,TP5组的停药率显著更高,复发率显著低于非TP5组。随访期间未出现副作用。

结论

TP5可有效降低复发率,且停药率更高,尤其是在儿童中。

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