How to treat the difficulty of stepping up?

summary

Adult patients may die of severe progressive myasthenia, dysphagia, malnutrition and respiratory failure caused by aspiration pneumonia or repeated pulmonary infection. Polymyositis complicated with heart and lung diseases is often serious and the treatment effect is not good. How to treat the difficulty of going up the steps? Next, I'd like to share my views with you.

How to treat the difficulty of stepping up?

Adrenocortical hormone is the first choice. Prednisone 40 ~ 60mg / D or more is given to acute patients. Continuous determination of serum muscle enzyme activity is the best method to observe the curative effect. Most patients' muscle enzyme decreased within 6 ~ 12 weeks after treatment and reached the normal level. Then the muscle strength was improved. Once the muscle enzyme content returned to normal, the muscle enzyme activity decreased, The dosage of prednisone should be reduced slowly; On the contrary, if the muscle enzyme increases, the dose should be increased

For adults, prednisone 10-15 mg / D is usually required for long-term maintenance. Some people have tried to stop prednisone, but rarely succeed. However, some patients can maintain for several years after effective treatment, and can gradually reduce the dose under close monitoring. The initial dose of prednisone in children should be large (30-60 mg / m2 per day). Prednisone can be stopped more than one year after remission, This is due to adrenocortical hormone induced myalgia. In this case, we must stop or reduce the use of hormone and replace it with other drugs such as immunosuppressants. For patients with myositis or inclusion body myositis whose tumor can not be resected or whose tumor has metastasized, hormone therapy is generally ineffective

Immunosuppressants, including methotrexate, cyclophosphamide, nitrogen mustard phenylbutyrate, azathioprine and cyclosporine, are beneficial to patients who have failed to respond to hormone therapy alone. Some patients have been treated with methotrexate alone (usually at a higher dose than RA) for more than five years to control the disease. The effect of intravenous immunoglobulin infusion is being evaluated, and the initial data are encouraging, However, the high price prevented further controlled trials. Myositis patients with malignant tumor could be relieved naturally if the tumor was removed

matters needing attention

Eggs are rich in high-quality protein, with 13 grams of protein per 100 grams of eggs. The protein content of two eggs is roughly equivalent to that of 50 grams of fish or lean meat. The digestibility of egg protein is also the highest in milk, pork, beef and rice.