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目的:探讨大剂量丙球蛋白(Ig)在抢救重症肌无力危象的临床疗效。方法:根据Qsseman分型,Ⅱa型2例、Ⅱb型8例、Ⅲ型13例、Ⅳ型3例MG危象患者在综合抢救的同时联合应用大剂量Ig静脉注射为治疗组。Ⅱa型1例、Ⅱb型6例、Ⅲ型15例、Ⅳ型2例综合治疗患者为对照组。以临床绝对评分及临床相对评分作为治疗前、后疗效判定标准,于治疗前、后2周抽清晨空腹血查AChRAb,观察治疗前、后重症肌无力的免疫状态的变化。结果:治疗组治疗前、后AChRAb有明显差异(P<0.01)。对照组治疗前、后无明显差异。临床评分两组治疗前、后均有明显差异(P<0.05),但治疗组治疗前、后分值差明显大于对照组(P<0.01)。经治疗后两组危象持续时间及有效率有明显差异(P<0.01)。结论:大剂量Ig在抢救MG危象中疗效明显、安全、可靠,值得临床应用。
Objective: To investigate the clinical efficacy of high-dose globulin (Ig) in rescue of crisis of myasthenia gravis. Methods: According to the Qsseman classification, 2 cases of type Ⅱa, 8 cases of type Ⅱb, 13 cases of type Ⅲ and 3 cases of type Ⅳ of MG crisis were treated with integrated intravenous injection of high-dose Ig at the same time. 1 case of type IIa, 6 cases of type IIb, 15 cases of type III and 2 cases of type IV as the control group. The clinical absolute score and clinical relative score were taken as the criteria for determining the curative effect before and after treatment. AChRAb was taken from morning fasting blood 2 weeks before and after treatment, and the changes of immune status of the patients with myasthenia gravis before and after treatment were observed. Results: There were significant differences in AChRAb before and after treatment in the treatment group (P <0.01). The control group before and after treatment no significant difference. Clinical scores were significantly different between the two groups before and after treatment (P <0.05), but the scores of the treatment group before and after treatment were significantly greater than those of the control group (P <0.01). After treatment, the duration of crisis and the effective rate of the two groups were significantly different (P <0.01). Conclusion: The high-dose Ig has obvious curative effect in rescuing MG crisis, which is safe, reliable and worthy of clinical application.