中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2013年
9期
726-729
,共4页
罗涵青%谭蓓%吕红%钱家鸣
囉涵青%譚蓓%呂紅%錢傢鳴
라함청%담배%려홍%전가명
Crohn病%结肠炎,溃疡性%贝赫切特综合征%药物不良反应%沙利度胺
Crohn病%結腸炎,潰瘍性%貝赫切特綜閤徵%藥物不良反應%沙利度胺
Crohn병%결장염,궤양성%패혁절특종합정%약물불량반응%사리도알
Crohn disease%Colitis,ulcerative%Behcet syndrome%Adverse drug reaction%Thalidomide
目的 分析免疫相关性肠病患者应用沙利度胺的药物不良反应(ADR),为临床安全用药提供指导.方法 对35例免疫相关性肠病患者[克罗恩病(CD)31例、溃疡性结肠炎(UC)2例、白塞病(BD)2例]应用沙利度胺治疗所发生的ADR进行随访分析,包括ADR种类、程度、发生时间以及神经毒性的剂量-效应关系.结果 35例患者应用沙利度胺的剂量为(109.29±30.37) mg/d,疗程(18.8±12.4)个月.ADR发生率为94.3％(33/35),位居前3位的ADR依次为手足麻木[51.4％(18/35)]、嗜睡[48.6％ (17/35)]和皮炎[37.1％ (13/35)],其用药至发生ADR的中位时间分别为6.50、0.25和1.00个月.因重度ADR而导致停药者占20.0％ (7/35),分别为周围神经炎3例、皮炎2例和骨髓抑制2例.周围神经炎的发生与沙利度胺的最大剂量及起始剂量无明显关联性(P＞0.05).结论 中等剂量沙利度胺在免疫相关性肠病治疗中ADR发生率虽较高,但多为轻度,可耐受,密切监测下多数患者可安全用药.
目的 分析免疫相關性腸病患者應用沙利度胺的藥物不良反應(ADR),為臨床安全用藥提供指導.方法 對35例免疫相關性腸病患者[剋囉恩病(CD)31例、潰瘍性結腸炎(UC)2例、白塞病(BD)2例]應用沙利度胺治療所髮生的ADR進行隨訪分析,包括ADR種類、程度、髮生時間以及神經毒性的劑量-效應關繫.結果 35例患者應用沙利度胺的劑量為(109.29±30.37) mg/d,療程(18.8±12.4)箇月.ADR髮生率為94.3％(33/35),位居前3位的ADR依次為手足痳木[51.4％(18/35)]、嗜睡[48.6％ (17/35)]和皮炎[37.1％ (13/35)],其用藥至髮生ADR的中位時間分彆為6.50、0.25和1.00箇月.因重度ADR而導緻停藥者佔20.0％ (7/35),分彆為週圍神經炎3例、皮炎2例和骨髓抑製2例.週圍神經炎的髮生與沙利度胺的最大劑量及起始劑量無明顯關聯性(P＞0.05).結論 中等劑量沙利度胺在免疫相關性腸病治療中ADR髮生率雖較高,但多為輕度,可耐受,密切鑑測下多數患者可安全用藥.
목적 분석면역상관성장병환자응용사리도알적약물불량반응(ADR),위림상안전용약제공지도.방법 대35례면역상관성장병환자[극라은병(CD)31례、궤양성결장염(UC)2례、백새병(BD)2례]응용사리도알치료소발생적ADR진행수방분석,포괄ADR충류、정도、발생시간이급신경독성적제량-효응관계.결과 35례환자응용사리도알적제량위(109.29±30.37) mg/d,료정(18.8±12.4)개월.ADR발생솔위94.3％(33/35),위거전3위적ADR의차위수족마목[51.4％(18/35)]、기수[48.6％ (17/35)]화피염[37.1％ (13/35)],기용약지발생ADR적중위시간분별위6.50、0.25화1.00개월.인중도ADR이도치정약자점20.0％ (7/35),분별위주위신경염3례、피염2례화골수억제2례.주위신경염적발생여사리도알적최대제량급기시제량무명현관련성(P＞0.05).결론 중등제량사리도알재면역상관성장병치료중ADR발생솔수교고,단다위경도,가내수,밀절감측하다수환자가안전용약.
Objective To investigate the safety of thalidomide in the treatment of immune-related bowel diseases for providing clinical reference.Methods Thirty-five patients with immune-related bowel diseases (31 Crohn's disease,2 ulcerative colitis and 2 Behcet's disease) treated with thalidomide were enrolled in this study.The incidence,type,severity,duration of thalidomide related adverse drug reaction (ADR) and the dose-effect relationship of neurotoxicity were analyzed.Results All the patients were treated with a mean dose of thalidomide (109.29 ± 30.37) mg/d for (18.8 ± 12.4) months,and 33 occurred ADR.The three most frequent ADR were numbness [51.4％ (18/35)],somnolence [48.6％ (17/35)] and dermatitis [37.1％ (13/35)].The median time to development of these three ADR were 6.50,0.25,and 1.00 months,respectively.Severe ADR leading to withdrawal accounted for 20.0％ (7/35),including reasons of peripheral neuritis (3/7),dermatitis (2/7) and myelosuppression (2/7).The incidence of peripheral neuritis was not significantly related to the maximal and initial dose of thalidomide (P ＞ 0.05).Conclusions Although the incidence of ADR was relatively high during the treatment of thalidomide,most of them were mild and well tolerated.Thalidomide can be safely used in patients with immune-related bowel diseases under close monitoring.
