摘要：

重症肌无力的治疗已进入靶向治疗时代。不同靶向疗法在重症肌无力致病机制的不同环节发挥作用。使用减少致病性自身抗体产生的免疫疗法才能长期稳定控制重症肌无力症状。糖皮质激素在自身抗体产生和免疫网络调节的多个环节起作用，使其成为重症肌无力治疗的基础。重症肌无力已有明确的治疗目标。在治疗达标过程的不同阶段，可单独使用激素，亦可与传统的免疫抑制剂或靶向疗法合用，通过评估是否具备传统激素升级策略治疗获益的特征，实施以激素为基础、以治疗达标为导向的个体化治疗方案，获得更好的长期疗效。

关键词: 重症肌无力, 糖皮质激素类, 治疗达标（非MeSH词）, 综述

Abstract:

Myasthenia gravis (MG) treatment has entered an era of targeted therapies. Different targeted therapies take effect in various aspects of pathogenic mechanisms in MG. For a steady long-term control of MG symptoms, immunotherapies that reduce the production of pathogenic autoantibodies should be used. The glucocorticosteroid acts on multiple aspects of pathogenic mechanisms relevant to autoantibody production and regulation of the immune network, which renders glucocorticosteroid the basis of MG therapy. A definite therapeutic target has been established in MG. Glucocorticosteroid can be used alone or in combination with traditional immunosuppressants or targeted therapies at different stages of the treat-to-target process. Based on the evaluation of the beneficial characteristics of patients using the traditional glucocorticosteroid escalation strategy, the implementation of the glucocorticosteroid-based and treat-to-target-oriented individualized treatment helps to obtain better long-to-term efficacy.

Key words: Myasthenia gravis, Glucocorticoids, Treat-to-target (not in MeSH), Review

中图分类号: 

• 重症肌无力

• 糖皮质激素类

• 治疗达标（非MeSH词）

• 综述

• Myasthenia gravis

• Glucocorticoids

• Treat-to-target (not in MeSH)

• Review