CAJ | 학술논문

目的评价依那西普治疗白塞病(BD)的疗效和安全性.方法 26例采用常规治疗无效的活动性BD患者纳入实验.停用所有既往治疗药物,改用依那西普25 mg,皮下注射,每周2次.在基线水平,第2、4、8、12、24周和停用依那西普12周时分别评价临床和实验室指标.结果依那西普在随访的各时间点对BD多有一定疗效.且以第2周较为显著:包括口腔溃疡、外阴溃疡、结节性红斑、假性毛囊炎和关节肿胀数(P<0.01).4例眼色素膜炎联合局部激素治疗缓解2例;1例回盲部溃疡治疗2个月愈合;4例副睾炎治疗4周全部缓解.红细胞沉降率(ESR)和C反应蛋白(CRP)在第2周均快速下降(P=0.012,P=0.013).停用依那西普12周时多数患者的评价指标恢复到原有水平.其中,CRP反弹最为显著[(481±312)mg/L与(549±267)mg/L,P=0.013],但关节肿胀数[(0.65±1.09)与(0.31±0.60),P<0.01]无明显复发.结论依那西酱对BD皮肤黏膜病变疗效确切、快速;对关节炎、眼炎、副睾炎和结肠溃疡也有一定有效.
목적 평개의나서보치료백새병(BD)적료효화안전성.방법 26례채용상규치료무효적활동성BD환자납입실험.정용소유기왕치료약물,개용의나서보25 mg,피하주사,매주2차.재기선수평,제2、4、8、12、24주화정용의나서보12주시분별평개림상화실험실지표.결과 의나서보재수방적각시간점대BD다유일정료효.차이제2주교위현저:포괄구강궤양、외음궤양、결절성홍반、가성모낭염화관절종창수(P<0.01).4례안색소막염연합국부격소치료완해2례;1례회맹부궤양치료2개월유합;4례부고염치료4주전부완해.홍세포침강솔(ESR)화C반응단백(CRP)재제2주균쾌속하강(P=0.012,P=0.013).정용의나서보12주시다수환자적평개지표회복도원유수평.기중,CRP반탄최위현저[(481±312)mg/L여(549±267)mg/L,P=0.013],단관절종창수[(0.65±1.09)여(0.31±0.60),P<0.01]무명현복발.결론 의나서장대BD피부점막병변료효학절、쾌속;대관절염、안염、부고염화결장궤양야유일정유효.
Objective To evaluate the therapeutic effect of etanercept in patients with Behcet's disease (BD). Methods Twenty six patients with active BD were eligible for anti-TNF-α treatment, which failed previously to commonly used drugs. All the patients were stopped previous therapy and treated with etanercept 25 mg twice a week. The clinical responses and laboratory parameters were evaluated at the baseline, week 2, 4, 8, 12 and 24, and week 12 of etanercept withdrawal. Results Etanercept was effective in several clinical lesions and lab. parameters at all time points. Especially at week 2, including oral ulcers, genital ulcers, erythema nodosum, pseudofolliculitis and swollen joints (P<0.01). Two of four cases of uveitis were contro-lled with addition of topical corticosteroids; The ileocecal junction ulcer of 1 patient healed after 2 months etanercept therapy; four cases of epididymitis reached complete remission at week 4. ESR(P=0.012) and CRP (P=0.013) were also rapidly decreased at week 2. Most patients were relapsed at week 12 of etanercept withdrawal compared with baseline except for swollen joints (0.65±1.09 vs 0.31±0.60, P<0.01) after etanercept withdrawal, in which the typical rebound was CRP from (481±312) mg/L to (549±267) mg/L (P=0.013).Conclusion Etanereept has rapid efficacy onset for most of the mucocutaneous disorders and possibly effective for arthritis, ophthalmitis, epididymitis and colonic ulcer of BD.