大剂量糖皮质激素联合免疫抑制剂治疗对行电视胸腔镜手术的重症肌无力患者的临床效果分析。
Analysis on the Clinical Effect of High-Dose Glucocorticoids Combined with Immunosuppressants on Patients with Myasthenia Gravis Undergoing Video-Assisted Thoracoscopic Surgery.
机构信息
Department of Neurology, Lanzhou University Second Hospital, Lanzhou, 730030 Gansu Province, China.
出版信息
Biomed Res Int. 2021 Dec 6;2021:5854056. doi: 10.1155/2021/5854056. eCollection 2021.
OBJECTIVE
The purpose of the study was to investigate the clinical effect of high-dose glucocorticoids (GCS) combined with immunosuppressants on the treatment of myasthenia gravis (MG) with video-assisted thoracoscopic surgery (VATS).
METHODS
A total of 106 MG patients admitted to the neurology department of our hospital from February 2016 to February 2020 were selected as the study subjects and divided into experimental group ( = 53) and control group ( = 53). The patients in the control group underwent VATS, while the patients in the experimental group were treated with high-dose GCS combined with immunosuppressants on the basis of VATS treatment. The clinical efficacy of different MG treatment methods was analyzed.
RESULTS
No significant differences were observed in visual analogue score (VAS) at T1 between the two groups ( > 0.05), while VAS scores at T2, T3, and T4 in the experimental group were significantly lower than those in the control group ( < 0.001). In the experimental group, the overall response rate was significantly higher than the control group ( < 0.05). Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) level in regulatory T (Treg) cells in experimental groups after treatment was significantly higher, compared to that in before treatment and the control group ( < 0.05). Similar results of each quantitative MG score were displayed in both groups after treatment, compared to before treatment and the control group ( < 0.05). Clinical performance of patients with lower incidence of adverse reactions in the experimental groups after treatment was significantly higher than those in the control group ( < 0.001).
CONCLUSION
GCS combined with immunosuppressants can effectively relieve patients' clinical symptoms and improve their quality of life, with significant clinical efficacy and high safety, which is worthy of application and promotion.
目的
本研究旨在探讨大剂量糖皮质激素（GCS）联合免疫抑制剂治疗电视胸腔镜手术（VATS）治疗重症肌无力（MG）的临床效果。
方法
选取 2016 年 2 月至 2020 年 2 月我院神经内科收治的 106 例 MG 患者为研究对象，分为实验组（n=53）和对照组（n=53）。对照组患者行 VATS 治疗，实验组患者在 VATS 治疗基础上加用大剂量 GCS 联合免疫抑制剂治疗。分析不同 MG 治疗方法的临床疗效。
结果
两组患者 T1 时视觉模拟评分（VAS）比较差异无统计学意义（>0.05），T2、T3、T4 时实验组 VAS 评分均明显低于对照组（<0.001）。实验组患者总有效率明显高于对照组（<0.05）。治疗后实验组调节性 T（Treg）细胞中细胞毒性 T 淋巴细胞相关蛋白 4（CTLA4）水平明显高于治疗前和对照组（<0.05）。两组患者治疗后各定量 MG 评分均明显低于治疗前和对照组（<0.05）。实验组患者不良反应发生率较低，治疗后临床症状改善情况明显优于对照组（<0.001）。
结论
GCS 联合免疫抑制剂能有效缓解患者的临床症状，提高生活质量，具有显著的临床疗效和较高的安全性，值得应用和推广。
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