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目的：探讨重症肌无力患者采用免疫球蛋白治疗的最佳剂量。方法：选择2007 年8 月到2014 年11月在我院收治的174 例重症肌无力患者，随机分为ACS组、小剂量IgG组和大剂量IgG组，分别每日静脉滴注15 mg 肾上腺素、250 mg 免疫球蛋白和 500 mg 免疫球蛋白进行治疗，对比三组的临床疗效、住院时间和呼吸机辅助时间。结果：经过治疗后，小剂量IgG 组与ACS组总有效率无显著性差异（P>0.05）；大剂量IgG 组总有效率明显高于小剂量IgG 组和ACS组，具有显著性差异（P<0.05）；大剂量IgG 组患者的住院时间和呼吸机辅助时间均明显少于ACS组和小剂量IgG组，具有显著性差异（P<0.05）。结论：500 mg 免疫球蛋白静脉滴注临治疗重症肌无力，临床疗效显著，能明显缩短患者的住院时间和呼吸机辅助时间，值得在临床上推广。

英文摘要:

Objective:To investigate the optimal dose of immunoglobulin in the treatment of patients with myasthenia gravis.Methods:A total of 174 patients with myasthenia gravis,who were admitted to Suining Center Hospital of Sichuan Province from August 2007 to November 2014, were selected and randomly divided into ACS group, light doses of IgG group and heavy doses of IgG group. And the three groups were respectively treated with daily intravenous infusion of adrenaline 15 mg, immunoglobulin 250 mg, and immunoglobulin 500 mg. The clinical efficacy,the hospitalization and the auxiliary time of ventilator of the three groups were compared.Results:The total effective rate of the heavy doses of IgG group was higher than those of the other two groups (P<0.05). There was no significantly difference between the ACS group and the light doses of IgG group (P>0.05). The hospitalization and the auxiliary time of ventilator of the patients in the heavy doses of IgG group were less than those in the other two groups (P<0.05).Conclusion:Intravenous infusion of 500 mg doses of immunoglobulin for the patients with myasthenia gravis has a significant clinical curative effect and can shorten the hospitalization time and the auxiliary time of ventilator of patients,which is worthy of clinical application.

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