克罗恩病长期应用硫唑嘌呤的疗效与安全性分析

The efficacy and safety of azathioprine in a long-term treatment for Crohn's disease

目的探讨克罗恩病长期应用硫唑嘌呤的疗效与安全性。方法回顾分析我院2003年~2010年应用硫唑嘌呤治疗的43例克罗恩病患者,评估其治疗前后克罗恩病活动指数,生物学指标,分析临床缓解和复发的相关因素,监测其不良反应。结果 43例患者（46.5%为女性）,克罗恩病确诊时的年龄为17~68岁,平均42.1岁,并且在确诊后服用硫唑嘌呤治疗的平均时间为1.6年,硫唑嘌呤剂量为1~2 mg/kg,克罗恩病患者的临床缓解率为69.8%（30/43）,治疗过程中8例出现白细胞下降,3例终止治疗、2例肝功能异常、1例因内瘘继发腹腔感染而死亡,未出现恶性肿瘤等严重不良反应,不良反应发生率为25.6%（11/43）。结论硫唑嘌呤用于克罗恩病需适量、长程及个体化治疗,可维持较长时间的临床缓解,降低并发症及其不良反应。

Objective To investigate the efficacy and safety of azathioprine in long-term treatment for Crohn＇s disease.Methods Forty-three Crohn＇s disease（CD） patients treated with Azathioprine in a long-term from 2003 to 2010 in Yangzhou first people＇s hospital were collected.Activity index（CDAI）,biology index,clinical manifestations and side effects were analyzed retrospectively.Results All the 43 CD patients（46.5% female） were treated with azathioprine（1～2 mg·kg-1·d-1） for an average 1.6 years after being made a definite diagnosis at the average age of 42.1 years old（17～68 years old）.The remission rate in 43 CD patients using azathioprine was 69.8%（30/43）.Leukocyte decrease were found in 8 cases,liver function abnormal were found in 2 cases,1 case of subsequent celiac infection died due to fistula,and 3 cases ceased treatment.No serious adverse reactions such as malignant tumor were found during treatment,and the rate of adverse reactions was 25.6%（11/43）.Conclusion Azathioprine can be used for CD in manner of adequate,long-term and individual therapy,and it can maintain a longer remission time,reduce complications and adverse reactions.