沙利度胺治疗炎症性肠病7例疗效  

Therapeutic Effect of Thalidomide in Treatment of Seven Patients with Inflammatory Bowel Diseases

作　　者：李明玮[1] 罗雯[1] 李扬[1] 李沛霖[2] 李泉[2] 王芳[2] 

机构地区：[1]首都医科大学附属复兴医院风湿免疫科,北京100038 [2]首都医科大学附属复兴医院消化内科,北京100038

出　　处：《中华临床免疫和变态反应杂志》2013年第1期56-62,I0003,共8页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的沙利度胺治疗炎症性肠病(inflammatory bowel disease,IBD)的临床疗效及安全性。方法 IBD患者(溃疡性结肠炎4例,克罗恩病3例)接受沙利度胺200mgd治疗,疗程24周。在治疗后2、4、8、12、24和48周时随访,计算国际IBD研究组织指数(International Organization for the Study of IBD,IOIBD)评分,并进行结肠镜、血细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(Creactive protein,CRP)的检查。同时严密监测任何不良事件。结果度胺治疗中、重度活动性IBD有效。治疗后4周内IOIBD评分下降幅度最大。所有患者炎性指标ESR、CRP水平在治疗后4周开始下降,治疗后24周所有患者镜下评分级别下调。所有患者均经历至少1个不良反应。结论沙利度胺对中、重度IBD患者具有抑制炎性反应、改善临床症状、促进肠黏膜修复及降低结肠镜下评分的作用。Objective To observe the therapeutic effect of Thalidomide treatment in patients with Inflammatory Bowel Diseases （IBD）. Methods Thalidomide, 200 mg/d, was used in seven patients with IBD （4 cases with Ulcerative Colitis, 3 cases with Crohn＇ s Disease, or called Segmental Enteritis） for 24 weeks. The follow-up visits were conducted at the time points of 2＇1＇1, 4＇h, 8th, 12th and 48th week. erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） were tested, proctocolonoseopy was carried out in order to calculate the indices of the inflammatory Bowel Disease （IOIBD）. The adverse events were strictly monitored and reported. Results Thalidomide is proved to be effective for IBD with moderate or high-level activity indices. After 4 weeks therapy, decrease is witnessed in IOIBD, as well as in ESR and CRP. The severity and activity in IBD is downgraded in all patients after twenty-four weeks of Thalidomide treatment. All patients have experienced at least one adverse event. Conclusions Thalidomide could inhibit inflammatory reaction, improve the intestinal mucosa repair and decrease the colonoscopy scoring for patients with IBD in middle or high-level severity and activity.

关 键 词：沙利度胺 炎症性肠病 肿瘤坏死因子-Α 溃疡性结肠炎 克罗恩病 

分 类 号：R574[医药卫生—消化系统]