吗替麦考酚酯治疗难治性自身免疫性肝病的临床研究

Clinical investigation of mycophenolate mofetil treatment for refractory autoimmune liver disease

目的探讨吗替麦考酚酯（MMF）对难治性自身免疫性肝病的疗效及安全性。方法回顾性分析6例传统治疗无效或不能耐受的自身免疫性肝病患者MMF治疗前后的疗效及生化指标的变化，记录治疗过程中出现的不良反应。结果4例ALT增高者，3例降至正常；5例碱性磷酸酶（ALP）增高者，4例下降超过50％；5例GGT增高者，下降均超过50％；2例IgG、γ-球蛋白增高者，均降至正常；2例总胆红素（TBIL）、直接胆红素（DBIL）、总胆汁酸、白细胞、血小板增高者，无变化。6例患者均未出现不良反应。结论MMF对早期的难治性自身免疫性肝病疗效良好，毒副作用小。

Objective To investigate the efficaey and safety of mycophenolate mofetil （MMF） for refractory autoimmune liver disease. Methods Six patients with autoimmnne liver disease who had failed tradional treatment or withdrew because of adverse reactions, had analysed retrospectively. The efficacy of the MMF treatment and variation of biochemical indexes, adverse effects of the MMF treatment were recorded. Results After MMF treatment, the serum levels of alanine aminotransferase （ALT） were decreased to normal level in three of four patients with higher ALT. The serum levels of alkaline phosphatase （ALP） were decreased to more than fifty percent of normal level in four of five patients with higher ALP. The serum levels of γ-glutamyhransferase （GGT） were decreased to more than fifty percent of normal level in all five patients with higher GGT. The serum levels of immunoglobulin G （IgG） and γ-globulin were decreased to normal level in all two patients who had elevated IgG and r-globulin levels. The serum levels of total bilirublin and total bile acid, the count of white blood cell and platelet had no change. There were no adverse effects in all six patients. Conclusion MMF treatment for early refactory autoimmune liver disease is effective with few side-effects.