低剂量环孢素治疗重度难治性溃疡性结肠炎

The therapeutic effect of low dose cyclosporine in treatment of severe refractory ulcerative colitis

目的:通过病例分析探讨环孢素在治疗重度溃疡性结肠炎激素治疗无效病例中的作用、用药方法以及血药浓度监测对临床治疗及药物不良反应发生危险的意义。方法:对3例确诊为重度溃疡性结肠炎并应用环孢素治疗病例的临床资料、环孢素用药方案及其血药浓度监测结果进行分析,结合文献复习,总结用药经验、临床疗效、血药浓度意义。结果:3例重度溃疡性结肠炎患者在激素治疗失败后应用低剂量环孢素治疗,用药期间血药浓度检测在有效安全范围内,平均1周后临床表现均获得改善,但组织学变化不一,未见严重不良反应。结论:环孢素对激素治疗无效的重度溃疡性结肠炎患者治疗有效,低剂量有助于在保证效果的情况下减少严重不良反应发生。血药浓度监测对临床用药有指导意义。

Objective:To evaluate the effect of low dose cyclosporine in treatment of severe refractory ulcerative colitis failed to response to steroids. Methods: The clinical data, dose regimen and serum level of cyclosporine from 3 cases of diagnosed severe refractory colitis failed to response to steroids who have received low dose cyclosporine therapy was studied retrospectively in combined with data from literatures. Results:The serum cyclosporine level was maintained at an effective and safe limit during therapy, clinical status was improved after l week of treatment, but histological changes was varied and no severe adverse reactions was observed in the retrospective study. Conclusion: Low dose cyclosporine is effective in treatment of severe refractory ulcerative colitis failed to response to steroids therapy,low dose is helpful to assure efficacy and to decrease adverse drug reactions. To monitor serum drug level is meaningful to clinical medication.