不同剂量甲基泼尼松龙治疗自身免疫性脑炎儿童的效果

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Abstract Objective To study the effect of different doses of Methylprednisolone in children with autoimmune encephalitis. Methods One hundred and eighty patients with autoimmune encephalitis admitted to Children′s Hospital of Hebei Province from February 2014 to February 2018 were selected as research objects and treated with Methylprednisolone, in addition, they were divided into low dose group [10 mg/(kg·d), 60 cases], medium dose group [20 mg/(kg·d), 60 cases] and high dose group [30 mg/(kg·d), 60 cases] by random number table method. The levels of against N-methyl-Daspartic acid receptor (NMDAR) antibody in serum and cerebrospinal fluid and the levels of immunoglobulin indices before and after treatment were compared among the three groups. The incidence of adverse reactions and mortality rate during treatment was recorded among the three groups. Results Six and twelve months after treatment, the levels of anti NMDAR antibodies in serum and cerebrospinal fluid of three groups were lower than those before treatment and 1 month, 3 months after treatment (P ＜ 0.05), which of the high, medium dose group were significantly lower than the low dose group (P ＜ 0.05), however, there was no significant difference between the high dose group and the medium dose group (P ＞ 0.05). Six months after treatment, the levels of immunoglobulin A, immunoglobulin G and immunoglobulin M in serum of the three groups were lower than those before treatment (P ＜ 0.05), which of the high dose group and medium dose group were significantly lower than the low dose group (P ＜ 0.05), however, there was no significant difference between the high dose group and the medium dose group (P ＞ 0.05). There were no significant differences in the incidence of cutaneous pruritus, impaired liver and kidney function, gastrointestinal bleeding and mortality rate among the three groups (P ＞ 0.05). How ever, the incidence of increased blood pressure and weight gain in the high dose group and medium dose group was higher than that in the low dose group (P ＜ 0.05). Conclusion The 20, 30 mg/(kg·d) doses of Methylprednisolone in the treatment of children with autoimmune encephalitis can ensure the efficacy of immunotherapy, and make the side effects of hormones within the tolerance range, which is worthy of clinical promotion.

Key words： Methylprednisolone Children Autoimmune encephalitis Adverse reactions

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	CHEN Fang SUN Suzhen WANG Wei DU Yakun MA Guilin TANG Hongxia ZHANG Xiaoqing LIU Kang

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CHEN Fang SUN Suzhen WANG Wei DU Yakun MA Guilin TANG Hongxia ZHANG Xiaoqing LIU Kang. Effect of different doses of Methylprednisolone in children with autoimmune encephalitis[J]. 中国医药导报, 2019, 16(23): 73-77,81.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I23/73

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