CAJ | 학술논문

目的评价他克莫司治疗全身型重症肌无力(MG)的疗效及不良反应.方法回顾性分析69例全身型MG患者接受他克莫司(2～6 mg/d)治疗前及治疗后1、3、6及12个月时MG严重程度评分及不良反应,并监测服药1个月后他克莫司血药浓度(FK506),分析其与临床疗效的相关性.结果他克莫司治疗1、3、6及12个月的总有效率分别为81.2％、87.6％、92.2％及93.8％.治疗1个月后,临床显效及好转组FK506[(7.1±3.9) μg/L,(6.3±3.8) μg/L]明显高于无效组[(3.4±1.3) μg/L] (P ＜0.01,P＜0.05).主要的不良反应:血糖升高5例,出现白细胞减少及头晕、耳鸣各3例.结论他克莫司治疗MG,起效快,临床疗效确切.在治疗剂量范围内其副作用小,主要为血糖升高及骨髓抑制.
목적 평개타극막사치료전신형중증기무력(MG)적료효급불량반응.방법 회고성분석69례전신형MG환자접수타극막사(2～6 mg/d)치료전급치료후1、3、6급12개월시MG엄중정도평분급불량반응,병감측복약1개월후타극막사혈약농도(FK506),분석기여림상료효적상관성.결과 타극막사치료1、3、6급12개월적총유효솔분별위81.2％、87.6％、92.2％급93.8％.치료1개월후,림상현효급호전조FK506[(7.1±3.9) μg/L,(6.3±3.8) μg/L]명현고우무효조[(3.4±1.3) μg/L] (P ＜0.01,P＜0.05).주요적불량반응:혈당승고5례,출현백세포감소급두훈、이명각3례.결론 타극막사치료MG,기효쾌,림상료효학절.재치료제량범위내기부작용소,주요위혈당승고급골수억제.
Objective To evaluate the efficacy and safety of tacrolimus in patients with generalized myasthenia gravis (MG).Methods A total of 69 cases admitted to our hospital were given 2-6 mg/day tacrolimus (FK506) for 12 months.The MG absolute and relative clinical scores were used to monitor the efficacy of tacrolimus.Clinical evaluation was conducted at month 1,3,6,and 12,while the serum concentration of FK506 was measured at one month after administration of tacromus for one month.Results The therapeutic response presenting as improved muscular strength showed within one month after administration of tacrolimus.The overall response rates (MG relative clinical score≥25％) at month 1,3,6 were 81.2％,87.6％,92.2％ respectively.It reached 93.8％ by the final visit at month 12.MG score to evaluate disease severity decreased significantly as the subjects continued to take tacrolimus.Statistic analysis suggested that the serum concentration of FK506 was correlated with its therapeutic effect.Serum trough levels in remission and response groups [(7.1 ± 3.9) μg/L and (6.3 ± 3.8) pg/L,respectively] were significantly higher than that of no response group [(3.4 ± 1.3) μg/L].The most common adverse effects included hyperglycemia (5 cases),myelosuppression (3 cases),and dizziness tinnitus (3 cases),majority of which were temporary and manageable.Conclusions Our study has shown that tacrolimus significantly improved muscular strength of generalized MG patients.The treatment is well tolerated.The therapeutic effect of tacrolimus is observed within 1 month after initial use.Adverse events were manageable and not common.