长期使用传统免疫抑制剂治疗皮肤病的不良反应比较

Comparison of the adverse effects of long-term use of conventional immunosuppressive agents in dermatology patients with dermatosis

目的:比较患者长期(>12周)使用各传统免疫抑制剂后出现的不良反应。方法:收集2019年1月至2023年10月期间长时间(>12周)使用甲氨喋呤、环磷酰胺、环孢素、吗替麦考酚酯和沙利度胺药物的患者检查资料,对血常规、肝功能、肾功能实验室检查进行回顾性分析。结果:共1507例使用传统免疫抑制剂患者纳入分析,其中甲氨喋呤1142例,环磷酰胺135例,环孢素67例,吗替麦考酚酯66例,沙利度胺97例,不良反应发生率分别为:38.18%,56.30%,44.30%,27.27%,22.39%。最常见的不良反应依次为肝功能损伤(24.22%),肾功能损伤(12.61%)和骨髓抑制(9.69%)。患者使用免疫抑制剂引起的不良反应发生率与用药时长存在相关性。结论:长期服用传统免疫抑制剂可导致不良反应的发生,最常引起不良反应的药物为环磷酰胺。因此,对于长期服用此类药物的患者应进行定期监测。

Objective:To compare the adverse effects following long-term(above 12 weeks)use of conventional immunosuppressive agents.Methods:The data of the patients with prolonged(more than 12 weeks)use of methotrexate(MTX),cyclophosphamide(CTX),cyclosporine(CsA),mycophenolate mofetil(MMF)and thalidomide(THD)with complete laboratory examination from January 2019 to October 2023,and their routine blood,liver function and renal function laboratory tests were retrospectively analyzed.Results:A total of 1507 patients using conventional immunosuppressants were analyzed,including 1142 using MTX,135 using cyclophosphamide CTX,67 using cyclosporine CsA,66 using mycophenolate mofetil MMF,97 using thalidomide THD,and the incidence of the adverse effects were 38.18%,56.30%,44.30%,27.27%,22.39%,The most common adverse reactions were liver function injury(24.22%),renal function injury(12.61%)and myelosuppression(9.69%).And there was a correlation between the duration of patient use and the incidence of adverse events with traditional immunosuppressive agents.Conclusion:Prolonged use of conventional immunosuppressive agents can lead to the development of adverse reactions,most commonly with the drug CTX,and therefore patients on long-term CTX should be monitored regularly.