克罗恩病超越10年的治疗经验和随访

Crohn’s disease, experience in long-term therapy and follow-up beyond ten years

克罗恩病是一种自身免疫疾病,其三联治疗是针对疾病的发病机制、病理生理及其病理变化进行多环节、多靶点治疗,达到抑制自身免疫、调节免疫、阻断或抑制其炎症反应的目的,疾病从活动至静止需要较长时间,因此治疗必须持之以恒。文内6例克罗恩病患者治疗与随访10年、11年、12年、13年各1例和15年2例,开始治疗应予足量三联药物直至肠镜下病变有显著改善才非常缓慢地减少激素用量直至授予硫唑嘌呤50 mg/d单药长期维持。激素的减量是根据肠镜下病变改善的程度,过早、过快地减量易致复燃。由于克罗恩病是自身免疫病,激素的应用是不可缺少的。

Crohn’s disease is an autoimmune disease, its triple therapy is directed against its pathogenesis, pathophysiology and pathologic features, aiming at inhibiting autoimmunity and interrupting the inflammatory cascade response . Proceeding of active status to inactive status often requires long-term therapy for years. Here we present six cases who have been treated and followed-up beyond ten years, i.e. 10, 11, 12, 13 years respectively in each of the four cases and 15 years in each of the two cases who are now at work or enjoying life at home. Adequate triple therapy should be given at the beginning, diminution of steroid dosage must be very slow and mainly rely on endoscopic findings improvement, early diminution or discontinuance can result in relapes. In our experience, glucocorticoid is indispensable drug for Crohn’s disease therapeutics.