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目的评价免疫抑制剂环孢素A(Cyclosporine A,Cs A)治疗全身型重症肌无力(myasthenia gravis,MG)的疗效及其不良反应。方法回顾性分析51例全身型MG患者接受Cs A治疗前及治疗后1、3、6、12个月时MG严重程度评分及不良反应,并通过监测患者服药1个月后血Cs A浓度,分析Cs A血药浓度与临床疗效的相关性。结果接受Cs A治疗1、3、6、12个月时的总有效率(临床相对评分≥25%)分别为78.4%、80.4%、84.3%、90.2%,且随服用Cs A时间的延长,MG临床绝对评分进一步下降(P<0.05)。临床显效及好转组患者血Cs A浓度[(97.3±25.4)ng/ml,(85.3±32.4)ng/ml]与无效组[(86.3±27.9)ng/ml]比较差异无统计学意义(P>0.05)。Cs A主要不良反应为肾功能损伤6例(11.8%),肝功能损伤3例(5.9%),胃肠道反应8例(15.7%)。结论 Cs A治疗全身型MG,起效快,临床疗效确切。
Objective To evaluate the efficacy and adverse reactions of immunosuppressant Cyclosporine A (CsA) in the treatment of systemic myasthenia gravis (MG). Methods A total of 51 patients with systemic MG were retrospectively analyzed for MG severity score and adverse reactions before CsA treatment and at 1, 3, 6 and 12 months after treatment. The levels of CsA, Analysis of CsA blood concentration and clinical efficacy of the correlation. Results The total effective rate (clinical relative score≥25%) at 1, 3, 6 and 12 months after CsA treatment were 78.4%, 80.4%, 84.3% and 90.2% respectively. With the prolongation of Cs A, MG absolute clinical score decreased further (P <0.05). There was no significant difference in serum CsA concentration between the two groups (97.3 ± 25.4 ng / ml, 85.3 ± 32.4 ng / ml vs 86.3 ± 27.9 ng / ml, P > 0.05). The main side effects of Cs A were renal damage in 6 cases (11.8%), liver damage in 3 cases (5.9%) and gastrointestinal reaction in 8 cases (15.7%). Conclusion Cs A treatment of systemic MG, rapid onset, the exact clinical efficacy.