Hill J C, Ivey A
Department of Opthalmology, Groote Schuur Hospital, Cape Town, South Africa.
Cornea. 1994 Sep;13(5):383-8. doi: 10.1097/00003226-199409000-00002.
In a previous study, we reported that a single intravenous pulse of 500 mg of methylprednisolone is more effective than oral prednisone in reversing rejection in patients who present early with severe endothelial rejection. In addition, the grafts that survived were less likely to undergo a further rejection episode. This study investigates whether a second pulse given at 24 h (n = 31) or at 48 h (n = 29) has any advantage over a single pulse (n = 30). All three treatment regimens were equally effective in reversing rejection (74.2%, 79.3%, and 83.3%, respectively), and there was no statistical difference in graft survival. An additional pulse therefore appears to offer no advantage over single pulse therapy. In high-risk grafts, current therapy has been reported to be less effective in reversing graft rejection. This study showed no significant difference between high- and low-risk grafts, indicating that pulse therapy may have a particular role in these difficult cases.
在之前的一项研究中，我们报告称，对于早期出现严重内皮细胞排斥反应的患者，单次静脉注射500毫克甲泼尼龙在逆转排斥反应方面比口服泼尼松更有效。此外，存活下来的移植物发生进一步排斥反应的可能性较小。本研究调查在24小时（n = 31）或48小时（n = 29）给予第二次脉冲与单次脉冲（n = 30）相比是否具有任何优势。所有三种治疗方案在逆转排斥反应方面同样有效（分别为74.2%、79.3%和83.3%），移植物存活率无统计学差异。因此，额外的脉冲似乎并不比单次脉冲疗法更具优势。在高风险移植物中，据报道目前的治疗方法在逆转移植物排斥反应方面效果较差。本研究显示高风险和低风险移植物之间无显著差异，表明脉冲疗法在这些困难病例中可能具有特殊作用。
