Comparative Study On The Efficacy And Safety Of Azathioprine And Cyclosporine A In Immunosuppression Of Generalized Myasthenia Gravis

Objective: Myasthenia gravis(MG)is an autoimmune disease caused by antibody-mediated neuromuscular junction transmission disorders that cause muscle weakness.Generalized MG(GMG)may develop into refractory MG,and some patients may have respiratory muscle weakness leading to death.Both azathioprine(AZA)and cyclosporine A(CyA)are immunosuppressive agents that can be used in GMG,but the specific choice for clinical application is inconclusive.This study aims to provide a reference for the clinical selection of AZA or CyA immunosuppressive GMG by comparing the efficacy and safety of these two drugs.Methods: From January 2018 to April 2019,20 outpatients and inpatients diagnosed as GMG in the Department of Neurology of the 940 th Hospital of the Joint Support Force of the Chinese People's Liberation Army were selected.According to the random results of the random number table and the patient's wishes,divide study subjects into 13 cases in the AZA group and 7 cases in the CyA group;the AZA group was given pyridostigmine bromide+glucocorticoid+AZA,and the CyA group was given pyridostigmine bromide+glucocorticoid+CyA.Collect baseline data and clinical scores,laboratory test indicators,and adverse reactions at 1,2,3,6,and 9 months of medication,and use SPSS 24.0 statistical software to build a database and statistical analysis.Results:1.A total of 20 patients with GMG were included,17 patients were followed up,3 patients were lost to follow-up,and the rate of lost follow-up was 15%.2.The difference in scores of AZA group(p=0.000)and CyA group(p=0.001)at different times were statistically significant.With the prolongation of medication,the scores decreased significantly,suggesting that the treatment of AZA and CyA drugs is effective;comparing and analyzing the efficacy judgment and total effective rate between the two groups,the difference was not statistically significant(all p>0.05);comparing and analyzing the scores of the two groups at baseline and taking medicines for 1,2,3,6,and 9 months statistical significance(all p>0.05).3.The adverse reactions of the two groups were mainly liver and kidney dysfunction,most of which were grade ? and IV with low toxicity.There was no lethal grade ? adverse reaction.The patients with adverse reactions alleviated after active treatment,and no irreversible remains organ dysfunction;comparative analysis of the incidence of adverse reactions and the severity of adversereactions between the two groups,the difference was not statistically significant(all p>0.05);comparative analysis of changes in blood cells,liver function,and renal function between the two groups at baseline and There was no statistically significant difference in taking 1,2,3,6,and 9months(all p>0.05).Conclusion: AZA and CyA are safe and effective in immunosuppressive therapy for GMG.There is no statistically significant difference in the effectiveness and safety of the two.Therefore,in clinical practice,AZA and CyA in the immunosuppressive therapy of GMG there maybe no difference in the choice,you can choose.