二甲双胍干预皮肤黏膜型白塞病的前瞻性临床研究  

A prospective clinical study of metformin for Behcet's disease of mucocutaneous type

作　　者：陈永[1] 罗丹[1] 邹峻[1] 申艳[1] 蔡剑飞[1] 鲍华芳[1] 管剑龙[1] 

机构地区：[1]复旦大学附属华东医院免疫风湿科,上海200040

出　　处：《暨南大学学报（自然科学与医学版）》2016年第5期372-377,共6页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：上海卫生系统第二批重要疾病联合攻关重点项目(2014ZYJB0010)

摘　　要：目的:探索二甲双胍对白塞病的临床治疗价值.方法:记录15例活动期白塞病患者经二甲双胍治疗入院时、出院时临床症状、血常规、C-反应蛋白、血沉、肝肾功能、血糖水平,作历史对照;并随访3月,记录疾病控制情况及副作用发生情况.结果:患者出院时临床症状均得到控制,口腔溃疡评分较入院时明显下降(P=0.000 0),每月复发次数,较入院前明显下降(P=0.000 1).患者治疗炎症指标包括白细胞计数、C-反应蛋白、血沉和Ig A明显下降(P<0.05).患者出院时,未发现二甲双胍对红细胞计数、血红蛋白明显影响,未发现对肝肾功能及血糖影响.同时发现患者谷氨酸-丙酮酸转氨酶治疗后下降,肾小球滤过率升高(P<0.05).6例(40%)患者出现腹泻,4例(27%)患者出现恶心、呕吐、食欲下降,2例(13.3%)患者出现乏力,尚可耐受.结论:二甲双胍可降低白塞病皮肤黏膜病变复发率,降低活动期血沉、C-反应蛋白,可能是白塞病治疗可供选择的药物之一.Aim：To investigate the potential clinical value of metformin for Behcet＇s disease （BD）. Methods：Clinical manifestations,blood routine test,C-reactive protein （CRP）,erythrocyte sedimentation rate （ESR）,liver and kidney function blood tests,blood glucose on the day of registration and discharge of 1 5 cases of BD patients treated by metformin were recorded.Follow up the patients for 3 months to investigate the effectiveness and side effects.Results：On discharge,symptoms of all patients were well controlled,oral ulceration score and relapse times were significantly decreased by follow up of 3 months later （P =0.0000 and 0.0001 ）.Inflammatory markers including WBC,CRP,ESR and IgA were dramatically decreased （P 〈0.05 ）.No obvious affects on RBC,hemoglobin,liver and kidney function and blood glucose.Interestingly,decreased serum ALT,and increased EGFR were observed （P 〈0.05）.Side effects are diarrhea （6 cases,40%）,nausea,vomiting and poor appetite （4 cases, 27%）and fatigue （2 cases,1 3.3%）.Conclusion：Metformin can reduce the recurrence rate of mucocutaneous lesions in BD,and reduce ESR、CRP in active phase,which indicate metformin might be a potential effective option for BD.

关 键 词：白塞病 二甲双胍 临床研究 炎症 血糖 副作用 

分 类 号：R597.9[医药卫生—内科学]