环孢素治疗重度溃疡性结肠炎临床分析

Clinical analysis of cyclosporin for severe ulcerative colitis

目的研究环孢素(cyclosporine A,CsA)治疗重度溃疡性结肠炎的临床疗效及其副作用。方法选取2016年3月~2018年2月12例重度溃疡性结肠炎住院患者进行研究,所有患者应用激素无效,其中6例患者应用英夫利昔单抗转换治疗无效或缓解后复发,对以上12例患者应用CsA进行补救治疗,记录患者在应用CsA后的第3 d、7 d以及14 d时的临床症状以及Mayo评分,监测药物副作用,并对患者进行3~14个月的随访。结果治疗后3 d、7 d、14 d时的Mayo评分较治疗前降低(P<0.05);CsA对重度溃疡性结肠炎诱导缓解有效率为75%(9/12);远期复发率较高为44.4%(4/9);血药浓度不高于260 ng/mL时,严重副作用很少。结论 CsA治疗重度溃疡性结肠炎能取得理想效果,且不良反应较少,值得临床推广。

Objective To study the clinical efficacy and side effects of cyclosporine A(CsA) in the treatment of severe ulcerative colitis. Methods Twelve patients with severe ulcerative colitis from March 2016 to February 2018 were selected. All patients were ineffective with hormones, and 6 of them were ineffective in switching therapy with infliximab or relapsed after remission. CsA was applied to the above 12 patients for salvage treatment, the clinical symptoms and Mayo score were recorded on the 3 rd, 7 th and 14 th day after the application of CsA, the side effects of the drugs were monitored, and the patients were followed up for 3 to 14 months. Results The Mayo scores on 3, 7 and 14 days after treatment were lower than those before treatment. The effective rate of CsA in inducing remission of severe ulcerative colitis was 75%(9/12);the long-term recurrence rate was 44.4%(4/9);when the blood concentration was not higher than 260 ng/mL, serious side effects less. Conclusion CsA can achieve ideal results in the treatment of severe ulcerative colitis, and has fewer adverse reactions, which is worthy of clinical promotion.