考来烯胺治疗胆汁酸性腹泻的疗效分析

The therapeutic effect analysis of Cholestyramine for bile acid diarrhea patients

目的 观察国产考来烯胺(消胆安)对胆汁酸性腹泻(bile acid diarrhea, BAD)患者的治疗效果。方法 采用前瞻性研究的方法,对15例BAD患者予考来烯胺治疗,观察治疗效果、不良反应及停药原因,并测定服药后及停药后血清胆汁酸前体C4及成纤维细胞生长因子19(fibroblast growth factor 19,FGF19)的变化。观察周期1年。结果 66.7%(10/15)的BAD患者在服用考来烯胺3 d内腹泻症状明显好转;无严重不良反应(serious side effects, SSE)发生;66.7%(10/15)患者在1年内停药,停药主要原因为不能耐受长期用药(long-term administration intolerance, LTAI)。服药1~2周后血清C4浓度逐渐上升,血清FGF19浓度逐渐下降;而停药后血清C4及FGF19呈相反的变化趋势。结论 国产考来烯胺对BAD患者止泻效果显著,起效快且不良反应可控。服用考来烯胺对血清C4及FGF19产生可逆影响。

Objective To observe the therapeutic effects of Cholestyramine for bile acid diarrhea(BAD)patients.Methods This was a prospective and observational study for one year.15 BAD patients were administrated with Cholestyramine.The effects,side effects,as well as the levels of fibroblast growth factor 19(FGF19)and 7α-hydroxy-4-cholesten-3-one(C4)were observed.Results 10 out of 15 patients received the obvious or complete remission within 3 days.There were no serious side effects(SSE)occurred.But 66.7%(10/15)patients stopped the Cholestyramine within 1 year,the main reason is long-term administration intolerance(LTAI).FGF19 and C4 had a reverse change after administration or withdraw Cholestyramine.Conclusion Cholestyramine is effective for most BAD patients,with fast onset and controllable adverse reactions.The influence on serum FGF19 and C4 is reversible.