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用类固醇治疗900例重症肌无力患者,结果出现9例股骨头缺血性坏死,发生率为1%。男6例,女3例,年龄22～60岁。骨坏死的发生与开始3个月用类固醇的总量大小有关,而与总疗程无关。在开始3个月的总量<3.6g的725例患者中,无1例发生骨坏死者,而在≥3.6g的175例患者中骨坏死9例,高达5%,二者有显著性差异(P<0.001)。经1～12年的随访,发现早期停止用药可使病情稳定且偶见改善。早期作骨减压术可使症状消失。为防止这一合并症的发生,应尽量减少开始3个月激素的总量,特别是对30岁以上的患者尤其应引起重视。
900 patients with myasthenia gravis steroid treatment, resulting in 9 cases of avascular necrosis, the incidence was 1%. 6 males and 3 females, aged from 22 to 60 years old. The incidence of bone necrosis with the first three months the total amount of steroid size, but not with the total course of treatment. None of the 725 patients with a total volume of <3.6 g at the first 3 months had osteonecrosis, whereas 9 of the 175 patients ≥ 3.6 g had osteonecrosis, up to 5%, both of which were significantly different (P <0.001). After 1 to 12 years of follow-up, found that early stopping medication can make the condition stable and occasional improvement. Early decompression can make the symptoms disappear. In order to prevent this complication, we should minimize the total amount of hormones in the first 3 months, especially for those over the age of 30. Pay more attention to it.