Dubowitz V
Arch Dis Child. 1976 Jul;51(7):494-500. doi: 10.1136/adc.51.7.494.
Analysis of the response to corticosteroid therapy in a personal series of 8 consecutive cases of dermatomyositis in childhood shows that there are advantages in a moderate dosage, short-term treatment schedule, with gradual tapering of the dosage as soon as there is clinical improvement without waiting for full remission, and in trying to stop steroid therapy within six months rather than following the more prolonged regimen currently still in vogue. Clinical response is a more reliable guide to progress than serum enzyme levels. Review of published reports suggests that overtreatment with corticosteroids may be a factor in chronicity of the disease and failure of adequate long-term response.
对本人所治疗的8例儿童皮肌炎连续病例的皮质类固醇治疗反应分析表明,中等剂量、短期治疗方案具有优势,一旦有临床改善,不必等待完全缓解,即可逐渐减少剂量,并尽量在6个月内停止类固醇治疗,而不是沿用目前仍流行的更长疗程。临床反应比血清酶水平更能可靠地指导病情进展。对已发表报告的回顾表明,皮质类固醇过度治疗可能是导致该病慢性化和长期反应不佳的一个因素。