CAJ | 학술논문

目的：探讨甲氨蝶呤联合地塞米松鞘内注射治疗神经精神狼疮的最佳用药剂量。方法将64例神经精神狼疮病例随机分为对照组和高、中、低剂量组各16例。对照组应用激素常规全身治疗，观察组在此基础之上应用甲氨蝶呤联合地塞米松鞘内注射，不同分组采用不同剂量；比较各组治疗前后临床表现、血沉、脑脊液压力及蛋白化验改善情况。结果各组接受治疗后，上述各指标均优于治疗前，差异具有统计学意义(P均＜0.05)；与对照组相比，治疗后各观察组绝大多数观察指标均得到显著改善(P均＜0.05)，而高剂量组各方面改善情况优势明显。结论对于神经精神狼疮的治疗，在全身常规应用激素的基础上，我们推荐鞘内注射甲氨蝶呤联合地塞米松的最佳剂量均为20 mg。
목적：탐토갑안접령연합지새미송초내주사치료신경정신랑창적최가용약제량。방법장64례신경정신랑창병례수궤분위대조조화고、중、저제량조각16례。대조조응용격소상규전신치료，관찰조재차기출지상응용갑안접령연합지새미송초내주사，불동분조채용불동제량；비교각조치료전후림상표현、혈침、뇌척액압력급단백화험개선정황。결과각조접수치료후，상술각지표균우우치료전，차이구유통계학의의(P균＜0.05)；여대조조상비，치료후각관찰조절대다수관찰지표균득도현저개선(P균＜0.05)，이고제량조각방면개선정황우세명현。결론대우신경정신랑창적치료，재전신상규응용격소적기출상，아문추천초내주사갑안접령연합지새미송적최가제량균위20 mg。
Objective To discuss the optimal dose in the treatment of neuropsychiatric systemic lupus erythematosus by intrathecal injection with methotrexate and dexamethasone. Methods 64 cases with neuropsychiatric systemic lupus erythematosus were collected, and divided into the control group, the high dose group, the medium dose group, and the low dose group with 16 cases of each group randomly. The control group accepted glucocorticoid routinely, based on that each observation group accepted intrathecal injection with methotrexate and dexamethasone by different doses. Then we compared the erythrocyte sedimentation rate, the cerebrospinal pressure, the protein, and the clinical manifestation in each group according to the treatment. Results After the treatment, all the observed indicators above were improved signiifcantly(P<0.05). Most of the observed indicators were improved more obviously than the control group(P<0.05), and the high dose group were improved obviously. Conclusion For the treatment of neuropsychiatric systemic lupus erythematosus, we recommend that the optimal dose of methotrexate and dexamethasone by intrathecal injection were all 20 mg, based on the using of glucocorticoid routinely.