中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2013年
5期
312-315
,共4页
肖英莲%陈白莉%何瑶%高翔%胡品津%陈旻湖
肖英蓮%陳白莉%何瑤%高翔%鬍品津%陳旻湖
초영련%진백리%하요%고상%호품진%진민호
克罗恩病%沙利度胺%治疗结果%随访研究
剋囉恩病%沙利度胺%治療結果%隨訪研究
극라은병%사리도알%치료결과%수방연구
Crohn disease%Thalidomide%Treatment outcome%Follow-up studies
目的 观察沙利度胺对难治性CD的疗效及安全性.方法 纳入经糖皮质激素及硫唑嘌呤治疗无效或糖皮质激素依赖的中重度活动期CD患者21例,予沙利度胺100 mg/d睡前顿服,随访1年.对其临床疗效、内镜下表现及安全性进行评估.结果 21例难治性CD患者中,6例因不良反应停药,2例因无效停药,3例仍继续用药但未完成1年随访,10例完成1年随访.临床症状缓解、显效及无效分别占23.8％(5/21)、19.0％(4/21)及57.1％(12/21).内镜下黏膜愈合、好转及无改善分别占9.5％(2/21)、14.3％(3/21)及76.2％(16/21).不良反应发生率为71.4％(15/21),包括皮疹、便秘、嗜睡、手足麻木、白细胞减少和肌肉酸痛.出现不良反应的平均时间为3.4周.结论 沙利度胺对难治性CD具有一定疗效,可用于不愿使用生物制剂或手术的患者,但应注意其不良反应.
目的 觀察沙利度胺對難治性CD的療效及安全性.方法 納入經糖皮質激素及硫唑嘌呤治療無效或糖皮質激素依賴的中重度活動期CD患者21例,予沙利度胺100 mg/d睡前頓服,隨訪1年.對其臨床療效、內鏡下錶現及安全性進行評估.結果 21例難治性CD患者中,6例因不良反應停藥,2例因無效停藥,3例仍繼續用藥但未完成1年隨訪,10例完成1年隨訪.臨床癥狀緩解、顯效及無效分彆佔23.8％(5/21)、19.0％(4/21)及57.1％(12/21).內鏡下黏膜愈閤、好轉及無改善分彆佔9.5％(2/21)、14.3％(3/21)及76.2％(16/21).不良反應髮生率為71.4％(15/21),包括皮疹、便祕、嗜睡、手足痳木、白細胞減少和肌肉痠痛.齣現不良反應的平均時間為3.4週.結論 沙利度胺對難治性CD具有一定療效,可用于不願使用生物製劑或手術的患者,但應註意其不良反應.
목적 관찰사리도알대난치성CD적료효급안전성.방법 납입경당피질격소급류서표령치료무효혹당피질격소의뢰적중중도활동기CD환자21례,여사리도알100 mg/d수전돈복,수방1년.대기림상료효、내경하표현급안전성진행평고.결과 21례난치성CD환자중,6례인불량반응정약,2례인무효정약,3례잉계속용약단미완성1년수방,10례완성1년수방.림상증상완해、현효급무효분별점23.8％(5/21)、19.0％(4/21)급57.1％(12/21).내경하점막유합、호전급무개선분별점9.5％(2/21)、14.3％(3/21)급76.2％(16/21).불량반응발생솔위71.4％(15/21),포괄피진、편비、기수、수족마목、백세포감소화기육산통.출현불량반응적평균시간위3.4주.결론 사리도알대난치성CD구유일정료효,가용우불원사용생물제제혹수술적환자,단응주의기불량반응.
Objective To observe the efficacy and safety of thalidomide in refractory Crohn's disease (CD).Methods A total of 21 moderate or severe active CD patients were enrolled,who had no response to glucocorticoid and azathioprine treatment or steroid-dependent.The patients were administrated with thalidomide 100 mg/d before sleep and followed up for one year.The clinical efficacy,endoscopic findings and safety were evaluated.Results Among 21 refractory CD patients,six patients stopped medication due to adverse effect and two because of ineffectiveness,three patients continued medication not completed one year follow-up,10 patients completed one year follow-up.The clinical remission,effective and ineffective rates were 23.8％(5/21),19.0％(4/21) and 57.1％(12/21) respectively.Under endoscope,the mucosal healing,improvement and no improvement rates were 9.5％(2/21),14.3％(3/21) and 76.2％ (16/21) respectively.The adverse effect rate was 71.4％ (15/21) including rash,conspitation,sommolence,numbness of hands and feet,leucopenia and muscular soreness.The mean time of the adverse effects onset was 3.4 weeks.Conclusions Thalidomide is effective in refractory CD treatment and could be used in patients unwilling to use biological medication or receive surgery.But the adverse effects should be noted.
