本文選題：嗜酸細胞肉芽腫性多血管炎 + 糖皮質(zhì)激素�。� 參考：《中國臨床藥理學雜志》2017年10期

【摘要】：目的觀察嗜酸細胞肉芽腫性多血管炎(EGPA)患者經(jīng)糖皮質(zhì)激素和/或聯(lián)合免疫抑制劑治療的近期與遠期療效。方法收集自2008年1月至2016年2月我院收治的確診嗜酸細胞肉芽腫性多血管炎的36例病例的資料,所有患者給予藥物治療,包括但不僅限于糖皮質(zhì)激素,其余包括免疫抑制劑如環(huán)磷酰胺、硫唑嘌呤等;糖皮質(zhì)激素劑量及療程依據(jù)病情及治療反應(yīng)確定,糖皮質(zhì)激素包括靜脈及口服劑型,免疫抑制劑為靜脈劑型。觀察所有患者急性期治療前后臨床癥狀與實驗室檢查的前后對比評價近期療效。2016年9月,對所有患者進行門診及電話隨訪,評價遠期療效。結(jié)果初始治療為單藥糖皮質(zhì)激素的32例患者納入近期療效評價,所有患者的臨床癥狀均有不同程度的好轉(zhuǎn),治療前后嗜酸細胞計數(shù)分別為(1.48±0.81)×109/L,(0.22±0.36)×109/L,嗜酸細胞百分比分別為(17.35±8.50)%,(2.95±4.90)%,總免疫球蛋白E分別為(750.95±1040.11),(343.87±489.53)U·m L~(-1),C反應(yīng)蛋白(CRP)分別為(44.44±37.65),(17.80±13.29)mg·L~(-1),紅細胞沉降率(ESR)分別為(58.25±40.61),(23.55±10.34)mm·h-1,差異均有統(tǒng)計學意義(P0.05)。長期隨訪結(jié)果提示,患者五因素評分(FFS)越高,復(fù)發(fā)風險越高,遠期療效越差。結(jié)論糖皮質(zhì)激素對于EGPA急性期癥狀控制效果顯著;對于存在重要器官受累的患者糖皮質(zhì)激素的長期療效差,復(fù)發(fā)風險高,應(yīng)盡早給予免疫抑制劑等的聯(lián)合治療以減少疾病的復(fù)發(fā)。
[Abstract]:Objective to observe the short- and long-term effects of glucocorticoid and / or immunosuppressive agents on eosinophilic granulomatous polyvasculitis (EGPA). Methods data of 36 patients with eosinophilic granulomatous polyvasculitis admitted to our hospital from January 2008 to February 2016 were collected. All patients were treated with drugs including, but not limited to, glucocorticoid. The other included immunosuppressants such as cyclophosphamide, azathioprine, and glucocorticoid dosage and course of treatment were determined according to the condition and therapeutic response. Glucocorticoids included intravenous and oral dosage forms, and immunosuppressants were intravenous dosage forms. To observe the clinical symptoms of all patients before and after treatment and laboratory examination before and after comparative evaluation of short-term efficacy. In September 2016, all patients were followed up by outpatient and telephone to evaluate the long-term effect. Results 32 patients with single drug glucocorticoid were included in the evaluation of short-term curative effect. The clinical symptoms of all patients were improved in varying degrees. 娌葷枟鍓嶅悗鍡滈吀緇嗚優(yōu)璁℃暟鍒嗗埆涓，

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