【摘要】 目的:探讨丙种球蛋白联用泼尼松治疗重症肌无力的疗效及对血清乙酰胆碱受体抗体(AchRAb)、转化生长因子-β1(TGF-β1)及补体的影响。方法:选择我院2014年1月至2018年4月收治的99例重症肌无力患者,按简单随机数字表法分为56例对照组和43例观察组,对照组采用泼尼松治疗,观察组在对照组基础上联合丙种球蛋白治疗。比较两组临床疗效,不同时间点肌无力绝对评分,AchRAb、TGF-β1,补体水平,不良反应发生情况。结果:治疗后,观察组总有效率高于对照组,比较有统计学差异(P<0.05)。治疗前,两组肌无力绝对评分、AchRAb、TGF-β1及补体水平比较无统计学意义(P>0.05);治疗后3个月、治疗结束时,两组肌无力绝对评分、AchRAb水平均下降,观察组低于对照组,两组TGF-β1及补体水平均上升,观察组高于对照组,两组肌无力绝对评分、AchRAb、TGF-β1及补体水平在不同治疗方法、治疗时间上的差异有统计学意义(P<0.05)。两组均有乏力、食欲减退、血压下降、体重增加发生,组间不良反应发生发生率比较无统计学差异(P>0.05)。结论:丙种球蛋白联合泼尼松治疗重症肌无力的疗效优于泼尼松,能够降低血清AchRAb水平,促进TGF-β1和补体表达,用药安全可靠。更多还原

【Abstract】 Objective: To discuss the curative effect ofgamma globulin combined with prednisone in treatment myasthenia gravis and its effect on serum Acetylcholine receptor antibody(AchRAb), transforming growth factor-β1(TGF-β1) and complement. Methods: 99 patients with myasthenia gravis who treated from January 2014 to April 2018 in our hospital, according to the simple random number table method these patients were divided into 56 control group and 43 observation group. The control group was treated with prednisone, and the observation group was treated with gamma globulin on the basis of the control group. Then clinical efficacy,absolute score of muscular weakness, levels of AchRAb, TGF-β1, complement at different time points,and adverse reactions occurred in both groups were compared. Results: After treatment, the total effective rate of the observation group was higher than that of the control group, the difference was statistically significant(P<0.05). Before treatment, absolute score, levela of AchRAb, TGF-β1 and complement in both group were no statistically significant difference(P>0.05). 3 months after treatment and at the end of treatment, the absolute score of muscular weakness and level of AchRAb in both groups were decreased, and the levels of TGF-β1 and complement in the observation group were lower than those in the control group, while those in the observation group were higher than those in the control group, there were statistically significant differences in absolute scores, AchRAb, TGF-1 and complement levels between the two groups in terms of treatment methods and treatment time(P<0.05). Fatigue, appetite loss, blood pressure drop and weight gain occurred in both groups, and there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: The curative effect of gamma globulin combined with prednisone in the treatment of myasthenia gravis is superior to that of prednisone, which can reduce the serum AchRAb level, promote the expression of TGF-β1 and complement, and is safe and reliable.更多还原