摘要
目的 研究糖皮质激素治疗炎性脱髓鞘疾病对血压、血糖、外周血白细胞（WBC）、血脂、血钙和血磷的影响。方法选择15例诊断明确的中枢神经系统炎性脱髓鞘疾病患者，先分别给予甲泼尼松龙（M组）及地塞米松（D组）静脉滴注治疗，后改为口服泼尼松逐渐减量治疗，测定激素治疗前及治疗第1、2、3、7、14天空腹血糖（FPG）及三餐后2h血糖（2hPG）、血常规、血生化和血压。结果（1）与治疗前相比，M组FPG治疗后第1、2天显著升高（P〈0．01），第3天仍升高（P〈0．05）；第1～3天三餐后和第7天中、晚餐后2hPG显著升高（P〈0．01），第14天晚餐后2hPG升高（P〈0．05）。D组仅第2天中餐后2hPG升高（P〈0．05），余时间点血糖水平差异无统计学意义（P〉0．05）。（2）与治疗前相比，M组第7、14天和D组第7天外周血WBC计数、中性粒细胞（NEUT）计数均显著升高（P％0．01）。（3）与治疗前相比，第14天M组血高密度脂蛋白（HDL）升高（P％0．01）且比D组升高（P〈0．05）更明显。两组治疗前与治疗后第7、14天HDL水平差异无统计学意义（均P〉0．05）。（4）其他：两组各自血压、血钙、血磷、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、血尿素氮（BUN）、肌酐（CRE）治疗前后的差异无统计学意义（均P〉0．05）。结论甲泼尼松龙引起血糖一过性升高比地塞米松明显，两种激素均能引起血HDL、外周血WBC及NEUT计数升高，但对血压、其他血脂指标、肝肾功能、血钙、血磷的影响不明显。鉴于样本量较小。上述结论尚有待于进一步深入研究加以证实。
Objective To investigate the changes of glucocorticoids therapy on hematological indices in patients with inflammatory demyelinating disease. Methods Total of 15 patients with inflammatory demyelinating disease were divided into two groups. Ten cases received treatment with methylprednisolone （group M）, The other 5 cases received treatment with dexamethasone （group D）. All the patients received prednisone with intravenous dripping （i. v. ） then changed to oral administration with different dosage and extenuated gradually in these two treatment teams. Results （1）Blood glucose：The fasting plasma glucose （FPG） of patients in group M increased significantly on the first and the 2nd day after the treatment （P〈0. 01） and on the third day after the treatment the increasing was less （P〈0.05） ;The 2 h postprandial plasma glucose （2hPG） increased （P〈0.01） from the 1st to the 3rd day after treatment and the 2hPG （lunch, supper） still increased on the 7th day after treatment （P〈0.01）, and less increased on the 14th day （P〈0.05）. The 2hPG （lunch） of patients in group D increased on the 2nd day after the treatment （P〈0.05）. （2）Leukoeytes：the white blood cell count （WBC） and neutrophils （NEUT） of the patients in group M increased significantly （P〈0.01） on the 7th and the 14th day after treatment and those of the patients in group D increased significantly （P〈0.01） on the 7th day after treatment. （3） High density lipoproteins （HDL）： the HDL of the patients in group M increased more significantly （P〈0.01） than group D （P〈0.05） on the 14th day after treatment. （4）Others： Compared to prior treatment, blood pressure, blood calcium, phosphorus, alanine amino transferase （ALT）, aspartate aminotransferase （AST）, blood urea nitrogen （BUN） and creatinine （CRE） didn＇t change significantly （P〉0.05）. Conclusions Methylprednisolone could make patients blood glucose increase more significantly than dexamethasone. Both methylprednisolone and dexamethasone could cause HDL, WBC and NEUT increase, but bring little influence on blood pressure, blood calcium, phosphorus, ALT, AST, BUN and CRE. Since the sample capacity was limited, some conclusions should be confirmed by another study with more sample capacity.
出处
《中国神经免疫学和神经病学杂志》
CAS
2009年第1期12-16,共5页
Chinese Journal of Neuroimmunology and Neurology
关键词
甲泼尼松龙
地塞米松
血糖
白细胞
methylprednisolone
dexamethasone
blood glucose
leukocytes
